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Contents ID Authors Title Page Medical Physics (Radiotherapy) 1

1 R Zainon, Noorfatin Aida Baharul Amin and Mohamad Aminudin Said

A review of dose to extremities using conventional and automated radiopharmaceutical dispenser system

2

6 Reduan Abdullah, Suk Chiang Chen, Ahmad Zakaria, Mohd Zahri Abdul Aziz, Gokula Kumar Appalanaido and Muhammad Fadli Mohd Sepian

Dosimetric evaluation of organ at risk doses in image guided brachytherapy for cervical cancer: a single institutional experience

3

7 Sayid Mubarok, Wahyu Edy Wibowo and Supriyanto Ardjo Pawiro

2D dose reconstruction of IMRT patient-specific QA based on log file information

4

9 Nor Ain Rabaiee, Mohd Zahri Abdul Aziz, Abdul Aziz Tajuddin, Ahmad Lutfi Yusoff, Rokiah Hashim, Muhammad Fadhirul Izwan Abdul Malik and Reduan Abdullah

Elemental decomposition and fractional probability of photon interaction in Rhizophora spp. bonded with soy protein particleboard

5

16 Akbar Azzi, Dea Ryangga and Supriyanto Arjo Pawiro

Treatment planning system dose evaluation of air-gaps for small field FFF beam irradiation

6

26 Mohd Zahri Abdul Aziz, Mohd Fahrizuan Mohd Yusop, Nik Kamarullah Ya Ali, Suffian M. Tajudin, Hiroshi Iwase and Marianie Musarudin

Computed Tomography Room Shielding Calculation of 140 keV Photons Using Monte Carlo Simulation

7

28 Abdelmoneim Sulieman, Yousra Khairi, Maha Hassan, Hiba Omer and Esameldeen Babikir

Dosimetric comparisons between two and three dimensional treatments plans for prostate Cancer

8

33 Pradeep Baral Treatment planning comparison of fixed-beam IMRT, VMAT and Helical Tomotherapy for SBRT treatment of NSCLC

9

45 Jacob Mata, Randal Zandro Remoto and Lucille Abad

3D radiotherapy photon beam dosimetry using an AMPS-based polymer gel dosimeter with x-ray CT readout

10

48 Oluwaseyi Oderinde, Michael Akpochafor and Matthew Isinkaye

Monte Carlo source model of a high energy accelerator x-ray beam

11

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49 Mahbubunnabi Tamal and Rafidah Zainon

Intensity threshold based segmentation method for Positron Emission Tomography (PET) images: a review

12

60 Nadin Abualroos and Rafidah Zainon

A review on radiation shielding materials in nuclear medicine

13

64 Noorfatin Aida Baharul Amin and Rafidah Zainon

Fabrication of Anthropomorphic Tissue-equivalent Thyroid-neck Phantom use in Nuclear Medicine

14

65 Zabariah Zakaria, Noramaliza Mohd Noor and Mohd Zahri Abdul Aziz

Advanced thermoluminescence dosimetric characterization of fabricated Ge-doped optical fibres (FGDOF) for electron beams dosimetry

15

67 H.T. Zubair, Hafiz M Zin, A. Oresegun, Louay G.T., H.A. Abdul-Rashid, Z. Yusoff and D.A. Bradley

Optical fiber scintillators for pulse-by-pulse measurement of radiation doses in IMRT treatment plans

16

Medical Physics (Imaging) 17 10 Ratna Suffhiyanni Omar, Suhairul

Hashim, Sib Krishna Ghoshal and Nurul Diyana Shariff

Dose Assessment of 4- and 16-slices Multi-Detector Computed Tomography (MDCT) Scans

18

20 Abdullah Alsubaie, Leena Al Sulaiti, Eman Daar, Abdullah N Al-Dabbous, Mariem Chamakh, Maisarah Jaafar and D. A. Bradley

Elemental Evaluation of Urban Road Dirt via a Number of Analytical Techniques

19

31 Khairul Nizam Jaafar and Syahir Mansor

Accuracy of Standardized Uptake Value Measurements in metastatic lesion for 99mTc-HMDP bone SPECT/CT

20

31 Kamran Hameed, Rafidah Zainoon and Mahbubunnabi Tamal

Characterisation of photon counting cadmium zinc telluride (CZT) detector for preclinical imaging

21

34 Inayatullah Shah Sayed, Nurul Hazwani Md Jamal and Waliullah Shah Syed

Estimation of absorbed dose to lungs and heart in pediatric chest x-ray examination at different tube voltages: Phantom study

22

35 Inayatullah Shah Sayed and Nurfadhilah Hanani Yusri

Scattered radiation dose to caregivers’ in plain radiography: A case study

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37 Hanif Haspi Harun, Muhammad Khalis Abdul Karim, Nor Azura Muhammad, Sarawana Chelwan Muniandy and Akmal Sabarudin

Radiation dose and Size Specific Dose Estimate from CT Pulmonary Angiography examinations

24

38 Mohd Amirul Azrie Mohd Roslee, Ibrahim Lutfi Shuaib, Ahmad Fakharuddin Mohd Napi, Mohd Amir Syahmi Mat Razali and Noor Diyana Osman

Cumulative Effective Dose in Adult Patients Population Undergoing Repeated or Multiple Head CT Scanning.

25

42 Muhammad Kabir Abdulkadir, Nur Atikah Yusra Mat Rahim, Nur Syazwani Mazlan, Norfataha Mohd Daud and Noor Diyana Osman

Dose Optimisation in Paediatric CT Examination: Assessment on Current Scanning Protocols Associated with Radiation Dose Received

26

44 Asmah Bohari, Suhairul Hashim and Siti Norsyafiqah Mohd Mustafa

Scatter cloud radiation in fluoroscopy-guided interventional (FGI) room

27

46 Irman Abdul Rahman, Hur Munawar Kabir Mohd, Faizal Mohamed, Shahidan Radiman, Kenton P Arkill and David A Bradley

Small angle neutron scattering studies of dipalmitoylphosphatidylcholine-hyaluronic acid vesicle structural properties

28

51 Siti Nor Azizah Abdullah, Mohd Fahmi Mohd Yusof, Norlaili Ahmad Kabir, Rokiah Hashim and Abd Aziz Tajuddin

Mass attenuation coefficients of Rhizophora spp. particleboards incorporated with metal elements as shielding materials at 16.59-25.26 keV photons

29

53 Bindhu Christopher, Mayeen Khandaker, David Bradley and Panakal Jojo

Effects of mobile phone radiation on certain hematological parameters

30

54 Joe Arun Raja Ponnusamy and Nelson Kennedy Babu

Adaptive region growing image segmentation algorithms for Breast MRI

31

57 Faizal Mohamed, Irman Abdul Rahman, Mohd Idzat Idris, David Andrew Bradley, Muhammad Zul Azri Muhammad Jamil, Nur Ratasha Alia Md. Rosli, Marlida Md Nor and Siti Norsyafiqah Mohd Mustafa

Effect of Gamma Irradiation on Magnetic Gadolinium Oxide Nanoparticles Coated with Chitosan (Gd-CsNPs) as Contrast Agent in Magnetic Resonance Imaging

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62 Esam Mattar, Amna Al-Jabri, Khalid Alsafi, Abdelmoneim A. Sulieman and Ibrahim Suliman

Occupational Exposure of the operator Eye Lens in digital coronary angiography and interventions

33

70 Zafri Azran Abdul Majid, Siti Aisyah Munirah Bohang, Mohd Syahriman Mohd Azmi

A Study of the Effect of Various Objects’ Angulation from Central Location on Image Displacement due to X-Ray Beam Divergence (Image Technical Evaluation)

34

Clinical Oncology 35 23 Khadijah Abdul Hamid and

Mohammad Fitri Khalil Peritoneal-pleural Leaks Demonstrated by Peritoneal Scintigraphy: A case report

36

30 Ming Tsuey Chew, Andrew Nisbet, Masao Suzuki, Naruhiro Matsufuji, Takeshi Murakami, Bleddyn Jones, Mayeen Khandaker and David Andrew Bradley

Ion beams for space radiation radiobiological effects studies

46

40 Muhammad Adib Abdul Onny, Hazlin Hashim and Mohd Fahmi Shukur Ramli

68Ga-Prostate-Specific Membrane Antigen (PSMA) PET/CT, a superior modality in restaging of prostate adenocarcinoma. A case report.

47

47 Mohd Fazrin Mohd Rohani, Hazlin Hashim, Syed Ejaz Shamim, Norazlina Mat Nawi, Wan Fatihah Wan Sohaimi

Comparison of standardized uptake value maximum (SUVmax) between metastastic and degenerative joint disease of the spine using bone scintigraphy with single photon emission computed tomography/ computed tomography (SPECT/CT) in prostate cancer

49

56 Ainina Safian and Yong Qian Ying Case Report - IORT in Pantai Hospital Kuala Lumpur

51

58 Haruna S Jallow, Shahrul Bariyah Sahul Hamid and Siti Noor Fazliah Mohd Noor

Bioactive glass: exploring its potentials use for treatments based on in vivo and in vitro studies

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Cancer Cell Biology 53 8 Farah Wahida Ahmad Zaiki,

Sulaiman Md Dom Prenatal Ultrasound Induces Apoptotic Neurons and Glial Cells (AC) in Rabbit Fetal Brain: A Biochemical analysis

54

13 Mohamed Ait Erraisse, Wissal Hassani, Moulay Ali Youssoufi and Khalid Hassouni

HDR Brachytherapy in Reirradiation of Local Nasopharyngeal Recurrence

55

25 Husna Azdiyah Habit, Nursakinah Suardi, Shahrom Mahmud, Rabiatul Basria Smn Mydin and Siti Khadijah Mohd Bakhori

Cytotoxic Effects of Low-Level Laser Irradiation on Human Breast Cancer MCF-7 Cells: In Vitro Study

56

36 Siti Razila Abdul Razak, Nur Ainina Abdollah, Nabil Izzatie Mohamad Safiai, Muhammad Khairi Ahmad and Kumitaa Theva Das

Specific inhibition of miR130a using CRISPR/Cas9 induces the proliferation and migration of non-small cell lung cancer cell line

57

39 Nur Wahida Zulkifli and Nurulisa Zulkifle

Construction of Yeast Two-Hybrid (Y2H) Bait Vector for Screening of Selected Deubiquitinases (DUBs)-interacting Proteins

58

41 Muhammad Khairi Ahmad, Siti Razila Abdul Razak, Nur Ainina Abdollah and Kumitaa Theva Das

Generation of Indels for dual-specificity phosphatase 6 (DUSP6) gene suppression in colorectal cancer cell line via CRISPR-Cas9 system.

59

61 Auni Fatin Abdul Hamid and Shahrul Bariyah Sahul Hamid

Roles of lipids in development of anticancer drug resistance in MCF7 cells

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1

Medical Physics

(Radiotherapy)

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ID #1: A review of dose to extremities using conventional and automated radiopharmaceutical dispenser system

R Zainon1, N A B Amin1, M A Said2 1Oncological and Radiological Sciences Cluster, Advanced Medical and Dental Institute, Universiti Sains Malaysia, SAINS@BERTAM, 13200 Kepala Batas, Pulau Pinang, Malaysia; 2Department of Nuclear Medicine, National Cancer Institute, No. 4, Jalan P7, Presint 7, 62250 Wilayah Persekutuan, Putrajaya, Malaysia. Manual dispensing technique of radiopharmaceutical in nuclear medicine involves manual withdrawal of activity from an elution vial, from a combination of the syringe and elution vial activities, and preparation of individual radiopharmaceutical doses to patients. Commercial automated radiopharmaceutical dispensing system is available, but, the cost of the machine is very expensive. The main aim of this study is to review the radiation burden to extremities of nuclear medicine personnel during preparation and dispensing of radiopharmaceutical using manual and automated dispensing system. The manual dispensing technique is laborious, and it involves high extremity doses to nuclear medicine personnel even with the use of heavy shielded containers. Thus, nuclear medicine personnel receive radiation burden to the hands and whole-body resulting from the practice of preparation of radiopharmaceutical doses. It is reported that radiation doses to both the fingertip and finger base of nuclear medicine personnel that prepares the radiopharmaceuticals in a radionuclide dispensary are likely to receive high dose and may even exceed the dose limit if the radiation protection principle is not well implemented. Therefore, a critical analysis of the distribution of dose across the extremities of nuclear medicine personnel using both manual and automated dispensing system was performed in this study. The contribution to the dose from automated system significantly reduce the radiation dose to extremities using automated dispensing system. This review also highlights that there is an urgent need to have a system that allows a real-time calibration and withdrawal of radiopharmaceutical to reduce extremity and whole-body doses. Contact author: [email protected] Keywords: radiopharmaceutical, dispensing technique, dose to extremities

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ID #6: Dosimetric evaluation of organ at risk doses in image guided brachytherapy for cervical cancer : a single institutional experience

R. Abdullah1,2, M.F. Mohd Sepian1, C.S. Chiang1, K. Gokula2, A. Zakaria1, M. Z. A. Aziz3

1Medical Radiation Programme, School of Health Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan, 16150, Radiology and Oncology Cluster, 2Advanced Medical and Dental Institute, Universiti Sains Malaysia, Bertam, Penang, Postcode, Malaysia

The purpose of this study is to compare point doses recommended by International Commission on Radiation Units and Measurement (ICRU) with volumetric dose to 2cc based on dose volume histogram (DVH) analysis of organs at risk for three dimensional (3D) intracavitary brachytherapy. A retrospective study was carried out on 3 cervical cancer patients with a total of 6 fractions of CT-based high dose rate (HDR) intracavitary brachytherapy (ICBT) from December 2017 to May 2018. ICRU bladder (bICRU) and rectum (rICRU) points were defined according to ICRU Report 38 on the CT images. Post-treatment, outer wall of OARs was contoured and minimum dose to 2cc (D2cc) of the most irradiated part of the OARs was obtained from the dose-volume histogram (DVH). Total doses (external beam radiotherapy plus ICBT) were computed with ICRU point dose and D2cc and then compared. There were 2 out of 3 patients, 2 out of 3 patients, and none of patients exceeded the (GYN) GEC-ESTRO Working Group recommended tolerance doses for bladder, rectum, and sigmoid, respectively. The mean ICRU point doses and D2cc volume doses were found to be significantly different for bladder with average ratio of 1.35, but no difference was found for rectum with average ratio of 1.03.

Contact author: Reduan Abdullah; [email protected]

Acknowledgement: This study was supported financially by RUI Grant (No. 1001304/CIPPT/8011001) of the Malaysian Ministry of Higher Education.

Keywords: organ at risk doses, intracavitary brachytherapy, cervical cancer

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ID #7: 2D dose reconstruction of IMRT patient-specific QA based on log file information

S Mubarok1, W E Wibowo2, S A Pawiro1 1Department of Physics, Faculty of Mathematics and Natural Sciences, Universitas Indonesia, Depok, West Java 16424, Indonesia; 2Department of Radiotherapy, Cipto Mangunkusumo Hospital, Jakarta, 10430, Indonesia This study aimed to reconstruct the 2D dose distribution based on log file and use it for IMRT patient-specific QA. Log file of Varian Unique Linear Accelerator was extracted to calculate the fluence MU and then converted to 2D dose distribution using the modified Clarkson integration (MCI) method. All calculation were done using in-house software based on MATLAB version 2016a. This reconstruction using the assumption that cube water phantom was irradiated by 6 MV photon at source surface distance (SSD) 98.5 cm and depth at 1.5 cm. This 2D dose reconstruction was compared with EclipseTM treatment planning system (TPS) calculation. The evaluation was done at isocenter point and 2D evaluation using gamma index analysis. The evaluation was separated by the split field (large IMRT field) and non-split field (small IMRT field). The isocenter dose evaluation results were 89 % and 36% data for non-split field and split field had deviation below 3 %. The gamma pass-rate results for non-split field with 2%/2 mm, 3%/3 mm and 4%/4 mm criteria were above 84%, 90% and 95% respectively. On the other hand, the gamma pass-rate results for split field with 2%/2mm, 3%/3 mm and 4%/4mm criteria were above 78%, 85% and 90% respectively. This results showed that log file information can be used to reconstruct 2D dose distribution and potentially to be used for IMRT patient-specific QA. Contact author: [email protected] Acknowledgement: This research was funded by UI Research Grant or Hibah PITTA 2018. Keywords: log file, dose reconstruction, patient-specific QA

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ID #9: Elemental decomposition and fractional probability of photon interaction in Rhizophora spp. bonded with soy protein particleboard Nor Ain Rabaiee1, Mohd Zahri Abdul Aziz1, Abdul Aziz Tajuddin2, Ahmad Lutfi Yusoff3, Rokiah Hashim4, Muhammad Fadhirul Izwan Abdul Malik5, Reduan Abdullah6

1Advanced Medical and Dental Institute, Universiti Sains Malaysia, 13200 Bertam, Pulau Pinang, Malaysia; 2School of Physics, Universiti Sains Malaysia, 11800 Minden, Pulau Pinang, Malaysia; 3I Hospital Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia ;4School of Industrial Technology, Universiti Sains Malaysia, 11800 Minden, Pulau Pinang, Malaysia; 5Science and Engineering Research Center, Universiti Sains Malaysia Engineering Campus, 14300 Nibong Tebal, Pulau Pinang, Malaysia; 6School of Health Science, Universiti Sains Malaysia Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia Several solid water phantoms are not exactly equivalent to water (even though they were called with the similar name), as they consist of different mixtures and formulations. These materials should provide similar physicochemical properties, i.e. density and elemental composition at certain energy range, to that of the real soft tissue. Several studies have been conducted on the Rhizophora spp. wood and found its attenuation coefficient was similar to water. However, no similar study has yet been conducted on the Rhizophora spp. bonded with soy protein, as it is expected that the soy protein should improve the bonding and mechanical properties of the wood. In this work, the Rhizophora spp. bonded with soy protein particleboard was analysing for its elemental composition and future evaluated its probability of photon interaction using Monte Carlo simulation. The probability of photon interactions, i.e. photoelectric effect, Compton scattering and pair production, provides a comparable curve as the solid water phantom and water phantom at the energy range between 0.001 and 50.000 MeV. Meantime, the Monte Carlo simulation showed that the depth dose curves with respect to water for 6 and 10 MV photon beam were in an acceptable value with discrepancy less than 5 %. Therefore, results of this study support the comparable results on probability of photon interaction between Rhizophora spp. bonded with soy protein particleboard with the water. Contact author: [email protected] Acknowledgement: The authors would like to express their appreciation to the School of Industrial Technology, Universiti Sains Malaysia (USM); the Cluster of Oncological and Radiological Sciences, Advanced Medical and Dental Institute (AMDI); Department of Nuclear Medicine, Radiotherapy and Oncology, Hospital Universiti Sains Malaysia as well as the Science and Engineering Research Centre (SERC), Engineering Campus, USM. The authors would also like to thank the Ministry of Higher Education, Malaysia, for the research funding, i.e. the Fundamental Research Grants Scheme (FRGS) 203/CIPPT/6711341. Keywords: mangrove wood; water equivalent phantom; Monte Carlo, photon interaction, dose distribution

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ID #16: Treatment planning system dose evaluation of air-gaps for small field FFF beam irradiation

A Azzi1, D Ryangga2, SA Pawiro1 1Department of Physics, Faculty of Math and Natural Science, Universitas Indonesia, Depok, West Java, 16424, Indonesia; 2Department of Radiotherapy, Pasar Minggu Regional General Hospital, South Jakarta, Jakarta, 12550, Indonesia Many authors stated that cavities or air-gap was the main challenge of dose calculation for Head and Neck with Flattening Filter LINAC irradiation. The aim of this work was to evaluate the effect of air-gap inhomogeneity dose calculation of flattening-filter-free (FFF) small field irradiation. Monte Carlo (MC) simulation was employed to study the characteristics of FFF beam in heterogeneity region. Virtual phantoms of 0, 2, 4, 6, 8, 10, and 15 mm air-gaps were built for 1×1, 2×2, 3×3, 4×4 cm2 6 MV FFF dose calculation. The dose ratio of air-gaps to tissue-equivalent was calculated both in Anisotropic Analytical Algorithm (AAA) and MC. In addition, the dose difference of AAA and MC were evaluated inside and below the air-gaps. We found that the dose ratio of air to tissue-equivalent tend to decrease with larger field size. This correlation was linear with a slope of -0.198±0.001 and -0.161±0.014 for both AAA and MC, respectively. On the other hand, the dose ratio beneath the air-gap was slightly field size dependent. The AAA to MC dose calculation as the impact of air-gap thickness and field size was varied from 1.57 to 5.35% after the gap. Uniquely, the dose difference was found up to 134% for 15 mm air-gap at 1×1 cm2. The dose air to tissue-equivalent ratio decreased with smaller air gaps and larger field sizes. Dose correction for AAA calculation beneath air-gap could be ignored after the secondary buildup. However, it should be applied inside the air-gap for FFF dose calculation. Contact author: Akbar Azzi; [email protected] Keywords: dose calculation, flattenning-filter-free, air-gap, Monte Carlo, small field

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ID #7: Computed Tomography Room Shielding Calculation of 140 keV Photons Using Monte Carlo Simulation

M. F. Yusop1, N. Kamarullah Ya Ali2, S. M. Tajudin3, H. Iwase4,5, M. Musarudin, M. Z. Abdul Aziz1 1Oncological and Radiological Science Cluster, Advance Medical and Dental Institute, Universiti Sains Malaysia, 13200 Kepala Batas, Penang, Malaysia 2 Department of Radiology, Hospital Universiti Sains Malaysia,, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia 3Universiti Sultan Zainal Abidin, Faculty of Health Sciences, 21300, Kuala Nerus, Terengganu, Malaysia 4High Energy Accelerator Research Organization (KEK), 1-1Oho, Tsukuba, Ibaraki 305-0801, Japan 5Department of Accelerator Sience, Graduate University for Advanced Studies (SOKENDAI), 1-1 Oho, Tsukuba, Ibaraki 305-0801, Japan 6School of Health Sciences, Health Campus, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan

Corresponding author’s e-mail address: [email protected] In recent years, Computed Tomography (CT) modality has been frequently used for the diagnosis and treatment of a diseases. With the increased request on CT procedure, radiation risk to staff will also rise. The objective of this study is to calculate radiation photon dose level in CT console room shielded with concrete and Barium plaster using Monte Carlo simulation (PHITS code). The exact size of the staff room, CT control console room and CT scanner room were modelled and simulated using the PHITS code. The source was modelled by 140 keV photons emitted isotropically in the CT room at 2-meter height from the floor. The CT console room where selected for the assessment of the radiation dose due to the highest probability for radiation workers to receive occupational exposure in this area. The findings showed that the dose level was higher at the opposite to the CT control console. The data also showed that interactions of the primary beam with the concrete floor above the CT room produces secondary radiation in the respective room. Hence, the suitable shielding materials (Aluminium, Al and Zinc, Zn) and with thickness 1 and 5 cm were introduced in the simulations. At highest dose point in CT control room 1 cm of Zinc and reduce dose by 82% compared to only 4% using 1 cm of aluminium slab.

Keywords: PHITS, Monte Carlo, CT control console room, Aluminium, Zinc

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ID #28: Dosimetric comparisons between two and three dimensional treatments plans for prostate Cancer Yousra Khairi Mohamed1, Maha Hassan2 ,Einas AbdelRahman3, Hiba Omer4, Esameldeen Babikir5, Abdelmoneim Suleiman6*

1College of preparatory year, Aljuf University, Skaka, Aljuf, Kingdom of Saudi Arabia 2National Cancer institute,University of Cairo, Cairo Egypt 3College of preparatory year, Aljuf University, Al Qurayyat, Aljuf , Kingdom of Saudi Arabia 4College of Medicine, Deanship of preparatory year, Imam Abdulrahman Bin Faisal University, Dammam Kingdom of Saudi Arabia 5Bahrain University, College of Health Sciences, Allied Health Department.Radiologic Technology Program, Kingdom of Bahrain 6Radiology and Medical Imaging Department, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University. P.O.Box 422, Alkharj11943, Kingdom of Saudi Arabia

This study intended to compare between two-dimensional (2D) and three-dmensional (3D) techniques for external-beam radiation treatment for prostate cancer was conducted at the National Cancer Institute, Egypt. Dose homogeneity within the target volume and doses to critical organs, organ at risk (OAR) were evaluated. CT scans of 30 patients with localized prostate cancer (T2N0M0) were acquired and transferred to the treatment planning systems ((TPS), KonRad version 2.2.23 Siemens, Malvern, PA, USA). A comparison of the two techniques was performed using isodose distributions, and dose-volume histograms. For the planning target volume (PTV) , the average (V95%, V107%) in 2D technique 90.6%, 5.7% while, for 3D technique 94.9%, 3.8 respectively. However, a better distribution of dose received by the OAR is achieved using 3D as compared to that of 2D technique, with considerable sparing of bladder, rectum and head of both femora, which received unnecessary radiation doses using 2D techniques. The discrepancy is very noticeable in the: rectum, where the average (V70, V75 and D95) in 2D technique was found to be 35.5%, 32.2%, 34% while for 3D 8.4%, 0.2%, 12% respectively; and the bladder where the average (V40, V65) in 2D technique was found to be 80.8%, 74.9% while for 3D it was 20.4%, 17% respectively. 3D planning only for prostate cancer treatment provides better target coverage and reduces the dose to the OAR and is thus more appropriate for prostate cancer therapy. Multiple 3D field, did not result in major difference in target coverage compared to the 2D techniques. Contact author: Abdelmoneim Sulieman; [email protected] Keywords: prostate cancer; treatment planning; 2D plans; radiation risk

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ID #33: Treatment planning comparison of fixed-beam IMRT, VMAT and Helical Tomotherapy for SBRT treatment of NSCLC.

Pradeep Baral1, 4, Hasin Anupama Azhari1, Bai Xue2 and Golam Abu Zakaria1, 3

1Department of Medical Physics and Biomedical Engineering, Gono University, Dhaka, Bangladesh. 2Zhejiang Cancer Hospital, Hangzhou, China. 3Gummersbach Teaching Hospital, University of Cologne, Germany 4Kathmandu Cancer Centre, Tathali, Bhaktapur, Nepal

Abstract

Volumetric-modulated arc therapy (VMAT), fixed- beam (FB) and helical tomotherapy (HT) are the modalities capable of delivering intensity-modulated radiation therapy (IMRT) with Stereotactic Body Radiation Therapy (SBRT) in treating early-stage non-small cell lung cancer (NSCLC). The purpose of this study is to compare the three techniques in terms of dosimetric quality and treatment efficiency. Thirteen patients with early-stage NSCLC already treated with SBRT were re-planned for HT, VMAT, and FB-IMRT. Fixed-beam plans with nine to twelve fields, VMAT plans with two partial arcs, HT plans with 2.5 cm beam-width were generated. All plans were prescribed to deliver 50 Gy in five fractions i.e. 10 Gy in each fraction. Dose-volume histogram statistics, dose conformity, dose fall-off and treatment delivery efficiency were analyzed. VMAT and fixed-beam showed significant improvement over HT in terms of dose conformity to PTV and also dose fall-off beyond the PTV. In terms of OARs, VMAT resulted superior in spinal cord, heart and total lung (MLD) sparing. Number of monitor unit in VMAT and fixed beam were significantly lower than in HT whereas expected treatment delivery time was significantly lower in VMAT in comparison to HT and fixed-beam. VMAT plans provide overall better organ at risk (OAR) sparing when comparing to fixed-beam and HT. in addition, VMAT plans require smaller number of MUs and thus shorter treatment time than fixed-beam and HT. In conclusion, VMAT plans are superior both dosimetrically as well as in aspect of treatment efficiency. Contact Author: Pradeep Baral; [email protected] Key words: Lung SBRT, Fixed-beam IMRT, VMAT, Helical Tomotherapy

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ID #45: 3D radiotherapy photon beam dosimetry using an AMPS-based polymer gel dosimeter with x-ray CT readout Jacob Mata1, Randal Zandro Remoto1,2, Lucille Abad3

1The Graduate School, University of Santo Tomas, España Blvd., Manila, 1015, Philippines; 2National Kidney & Transplant Institute, East Ave., Diliman, Quezon City, 1101, Philippines; 3Department of Science and Technology - Philippine Nuclear Research Institute, Commonwealth Ave., Diliman, Quezon City, 1101, Philippines This study highlights the fabrication and dosimetric characterization of a polymer gel dosimeter (PGD) based on the 2-Acrylamido-2-methyl-1-propane sulfonic acid (AMPS) monomer for 3D radiotherapy photon dosimetry. Radiological properties and water/tissue equivalence were established for the AMPS-based PGD through determination of mass and electron densities (ρ and ρ e), effective atomic number (Zeff), and photon cross section. Calibration was performed through determination of dosimeter response based on CT Number (NCT) vs. DGy after irradiation of PGD in vials to known absorbed doses delivered by opposed lateral photon beams of a Cobalt-60 teletherapy machine and 6-MV linear accelerator and readout using a 16-slice X-ray CT scanner. The unirradiated PGD has ρe and ρ comparable to brain tissue (ICRU-44), and Zeff close to water. Results show a 0.584% difference in total attenuation cross-section of water for energies >1.0 MeV (NIST XCOM). Dosimeter response is bi-exponential with linear dose response from 0 to 5 Gy (0.445 HU Gy-1, R2 = 0.998) and dose resolution of 0.111 Gy. There was no observed energy dependence in the dosimeter while dose-rate dependence was only available at dose-rates < 200 cGy min-1. Finally, a 3D treatment plan verification of an arc plan on a larger dosimeter volume yielded a pass fraction of 96.85% after a gamma-index evaluation on the dosimeter readout compared with the planning data (3% dose difference, 3 mm distance agreement). Contact author: Jacob Mata; [email protected] Acknowledgement: The study is supported by the Department of Science and Technology through the Philippine Nuclear Research Institute under its GSRG program and the Science Education Institute through the National Science Consortium - University of Santo Tomas with its ASTHRD program. We would like to thank the Department of Radiotherapy of Jose R. Reyes Memorial Medical Center for allowing us to hold parts of the research in their Co-60 teletherapy facility. Keywords: AMPS, Polymer Gel Dosimetry, X-ray CT

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ID #48: Monte Carlo source model of a high energy accelerator x-ray beam

OM. Oderinde1,2, MO. Akpochafor3 and MO. Isinkaye4

1Department of Radiation Medicine and Applied Science, University of California San Diego, La Jolla, San Diego, California, USA 2Department of Physics, University of Witwatersrand, Johannesburg, Gauteng, South Africa 3Department of Radiation Biology, Radiotherapy, Radiodiagnosis and Radiography, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria 4Department of Physics, Faculty of Science, Ekiti State University, Ado Ekiti, Ekiti State, Nigeria

Purpose: The purpose of this study is to explicitly present the development of an accurate source

model for a high energy accelerator x-ray machine (Elekta Precise clinical linear accelerator)

situated at Lagos University Teaching Hospital (LUTH) Idi-Araba Lagos, Nigeria. At this

treatment center, the radiotherapy machine operates at nominal 6MV photon beam. Materials and methods: This EGSnrc-based MC study developed and validated the linac head

for 10 × 10 and 20 × 20 cm2 fields using the manufacturers’ specification and as well calculated

the dose distribution in a homogeneous water phantom. The BEAMnrc and DOSXYZnrc software suites were used appropriately for linac model and dosimetry respectively. The simulated data were benchmarked with measurements using the following characteristics; percentage depth doses (PDDs) and lateral dose profiles. Results: For this study, the simulated source model was accurate in terms of their characteristics.

On the average, the source model discrepancies fall within 2%/2 mm Gamma criteria. However,

at the penumbra regions, discrepancies were 2.2%/2 mm and 2.4%/2 mm for 10 × 10 and 20 × 20

cm2 fields respectively. Conclusion: This accurate source model shows the potential to be used for efficient and

effective dose calculation in patient specific radiotherapy treatment, checking the accuracy of

treatment planning system (TPS) calculation and further dosimetry studies.

Contact author: Oluwaseyi M. Oderinde; [email protected]

Keywords: Monte Carlo, BEAMnrc and DOSXYZnrc, accurate source model, Dosimetry

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ID #49: Intensity threshold based segmentation method for Positron Emission Tomography (PET) images: a review

M. Tamal1 and R. Zainon2. 1Department of Biomedical Engineering, Imam AbdulRahman Bin Faisal University, Dammam, Eastern Province, 1982-31441,Kingdom of Saudi Arabia . 2Oncological and Radiological Sciences Cluster, Advanced Medical and Dental Institute, Universiti Sains Malaysia, SAINS@BERTAM, 13200 Kepala Batas, Pulau Pinang, Malaysia, Diagnosis, treatment planning and response assessment of tumours using Positron Emission Tomography (PET) images require accurate, robust and reproducible segmentation of the tumours. Since standardized uptake value (SUV) – a normalized semiquantitative parameter that is conventionally used in PET is represented by the intensity of the PET images and related to the radiotracer uptake by the tumour and surrounding background organs or tissues, a SUV based threshold method is a natural choice to delineate the tumour from the background. However, due to low signal-to-signal ratio (SNR) and poor spatial resolution of PET camera along with the finite image sampling constraint, determining an optimum threshold value is a challenging task. The aims of this study are to review the fixed and adaptive threshold based PET image segmentation approaches utilizing a common mathematical framework and to highlight the advantages and disadvantages of these methods from the perspectives of diagnosis, treatment planning and response assessment. Several fixed threshold values have been proposed over the years ranging from 40% to 50% of the maximum SUV (SUVmax). It has been observed that the performance of the fixed threshold based method is very much dependent on the SNR, contrast and size of the tumour. To minimize these dependencies, different versions of the threshold based method that account for signal to background ratio and size of the tumour have been proposed. These methods are known as adaptive threshold based methods. Keywords: intensity threshold segmentation, PET, standardized uptake value (SUV)

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ID #60: A review on radiation shielding materials in nuclear medicine

Nadin Jamal AbuAlRoos1, Rafidah Zainon1

1 OncologicalandRadiologicalSciencesCluster,AdvancedMedicalandDentalInstitute–Universiti

SainsMalaysia,SAINS@BERTAM,13200KepalaBatas,PulauPinang,Malaysia.

Gamma ray is an energetic ionizing radiation that has the ability to damage living cells as

it slows down and transfers its energy to the surrounding cells. Shielding is essential in

protection against gamma ray hazards. Radiation shielding materials become very serious

issue, researchers are continuously looking for sustainable shielding material. Different

shielding materials have been produced to safeguard the human and the environment

from destructive impact of radiation throughout the past decades.

A good perceiving of gamma ray interaction with matter is the first key to find shielding

material with appropriate physical properties. Materials with high atomic number and

high-density elements imposed high probability of interactions and larger energy transfer

with gamma rays considered as a good choice for effective gamma shields. Heavy

materials known to have high ability in attenuation of gamma rays which is the most

important characteristic of a material protection.

The high atomic number and high-density materials such as lead, steel, tungsten and

concrete provide best effective shielding against Gamma-ray with taking into

consideration the toxicity of lead and the need of finding alternative material to replace it.

Numerous experimental and theoretical works have been performed on radiation

shielding. In this paper, the recent developments of materials used as gamma radiation

shielding in nuclear medicine applications are reviewed.

Contact author: Dr. Rafidah Zainon, [email protected]

Keywords: Ionising radiation, Gamma ray, shielding materials.

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ID #64: Fabrication of Anthropomorphic Tissue-equivalent Thyroid-neck Phantom use in Nuclear Medicine Noorfatin Aida B. A. 1, R. Zainon2

1Advanced Medical and Dental Institute, Universiti Sains Malaysia, Bertam 13200 ,Kepala Batas, Pulau

Pinang, Malaysia. 2School of Physics, Universiti Sains Malaysia, 11800 Minden, Pulau Pinang, Malaysia. The aim of this study was to fabricate anthropomorphic thyroid-neck phantom used in nuclear medicine. The phantom can be used for internal dosimetric studies and single-photon emission computed tomography (SPECT) imaging. The main structures of this fabricated anthropomorphic phantom was it included the neck shape, thyroid, trachea, oesophagus, cervical bone and spinal canal mimicking structure with optically stimulated luminescence dosimetry (OSLD) slots. All structures of this phantom are were fabricated using tissue-equivalent material of paraffin wax and sodium chloride (NaCl) compound. Technetium-99m (Tc99m) with an activity of 0.3 mCi and 2.0 mCi were administrated into the thyroid part and correspond structures of neck and spinal canal of the fabricated phantom which imitate the background radiation when radiophramaceutical administrated into human body. The OSLDs were inserted into the thyroid, spinal canal, trachea and eosophagus parts for dosimetry purposes while the images of these anthropomorphic tissue-equivalent thyroid-neck phantom were obtained using SPECT imaging. From the experiment using fabricated phantom, the effective dose measured at thyroid, oesophagus, trachea and spinal canal parts of phantom are 0.455mSv, 0.393 mSv, 0.427 mSv and 0.373 mSv respectively. The percentage difference between average effective dose of thyroid phantom calculated and ICRP report 53 is 31%. The fabricated anthropormorphic thyroid-neck phantom can be future use to study of radiation dosimetry under conditions very similar to those in patient. Internal dose radiation can be analyse for nuclear medicine procedures of thyroid using the fabricated phantom and dosimeters. Contact author: PresentingAuthor; [email protected] Acknowledgement: The author would like to acknowledge Nuclear Medicine Unit, Advanced Medical and Dental Institute in providing the radiopharmaceutical source and SPECT imaging. . Keywords: anthropomorphic phantom, tissue equivalent material, dosimetry, Tc99m, nuclear medicine.

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ID #65: Advanced thermoluminescence dosimetric characterization of fabricated Ge-doped optical fibres (FGDOF) for electron beams dosimetry

Z Zakaria1, 3, M Z Abdul Aziz2, N Mohd Noor1 1Department of Imaging, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor, Malaysia 2Oncological and Radiological Sciences Cluster, Institut Perubatan & Pergigian (IPPT), Universiti Sains Malaysia (USM), 13200, Bertam, Penang, Malaysia 3Universiti Kuala Lumpur British Malaysian Institute (UniKL BMI), Bt 8 Jalan Sg Pusu, 53100 Gombak, Selangor, Malaysia This work was investigated on an advanced dosimetric characteristic of fabricated Ge-doped optical fibres (FGDOF) for electron beams dosimetry in term of percentage depth dose (PDD) curves besides of basic characteristics of sensitivity, dose linearity, dose rates dependences, field sizes dependences and fading. The fibres used were different in shapes, cross-section dimensions and germanium concentrations. Responses of fibres are compared with commercial fibres, ionization chamber (IC) and GafchromicTM EBT3 films. All the fibres were irradiated using 6-, 9- and 12 MeV electron energies, 100 cm focus to sample distance (FSD) and 10 x 10 cm2 field size to the depth of dose maximum at the Royal Surrey County Hospital, England. The dose rates employed ranges from 100 up to 600 cGy/min and field size ranges from 6 x 6 cm2 to 25 x 25 cm2 respectively at fixed 9 MeV electron’s energy. For PDD curves, the fibres, IC and films were placed at the depth ranges from 0cm to 10cm. The water-to-air stopping power ratios and the fluence correction factors, Pfl were required in determining PDD curves when using ionization chamber. Thermoluminescence (TL) yields for the fibres showed high linearity (R2 > 0.99) compared to commercial fibres. A weak dependence showed on dose rates and field sizes dependences to within 5% for all fibres. The highest sensitivity and minimum TL fading for up to three months were reported for a 2.3 mol% flat fibre (FF). Differences of up to 3% were identified between the PDDs measured using IC and FGDOF. Contact author: [email protected] Acknowledgement: The authors warmly thank the staff of Medical Physics Department at the Royal Surrey County Hospital for the irradiations assistance. Universiti Putra Malaysia (UPM) is gratefully acknowledged for financial support through Putra grant (project no: 9615500). Keywords: thermoluminescence, depth of dose maximum, Ge-doped optical fibres

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ID #67: Optical fiber scintillators for pulse-by-pulse measurement of radiation doses in IMRT treatment plans H.T. Zubair1, Hafiz M Zin2, A. Oresegun1, G.T. Louay1, H.A. Abdul-Rashid1, Z. Yusoff1, D.A. Bradley3, 4

1Fibre Optics Research Centre, Faculty of Engineering, Multimedia University, Jalan Multimedia 63100, Cyberjaya, Malaysia. 2Advanced Medical and Dental Institute (AMDI), Universiti Sains Malaysia, Penang, Malaysia. 3Centre for Radiation Sciences, Sunway University, 46150 PJ, Malaysia 4Department of Physics, University of Surrey, Guildford, GU2 7XH, UK

Specialised treatment modalities in radiation therapy such as Intensity Modulated

Radiation Therapy (IMRT) demand for radiation sensors with high spatial resolution and

fast response. More than 60% of cancer patients receive a form of radiation therapy to

manage the tumour. Scintillation dosimetry utilizing fibre optic coupling arrangement has

emerged as one of the most promising candidates for small-field ionizing radiation dose

measurements. Recent advances have also explored the possibilities of in vivo dose

measurements using similar apparatus. In this study, phosphorus-doped silica optical fibre

scintillators, fabricated in-house using Modified Chemical Vapour Deposition (MCVD)

technique, have been developed in conjunction with a fibre optic coupled

radioluminescence (RL) signal acquisition system. Together, they make a real-time,

remote dosimetry system for use in megavoltage X-ray environment (radiotherapy range).

The ‘real-time’ feature can be extended to pulse-by-pulse measurements of linac beams,

where each pulse ideally delivers ~0.23 mGy at 6MV, and ~0.45 mGy at 10MV. This

feature has significant value, when treatment plans involve variable dose rates. Feasibility

of pulse-by-pulse measurements of linac beams using P-doped silica optical fibre

scintillators (of varying dimensions and composition) has been experimentally investigated

in IMRT treatment plans achieving a Radioluminescence (RL) response with precision

level ±3% satisfying the International Atomic Energy Agency (IAEA) TRS-98

specifications.

Contact author: H.T. Zubair; [email protected]

Keywords: Radioluminescence, Time-resolved Dosimetry, Optical Fibre Scintillator

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Medical Physics

(Imaging)

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ID #10: Dose Assessment of 4- and 16-slices Multi-Detector Computed Tomography (MDCT) Scans

R. S. Omar1, S. Hashim1, S. K. Ghoshal1, N. D. Shariff2 1,Universiti Teknologi Malaysia, Skudai, Johor, 81310, Malaysia; 2Hospital Sultanah Aminah, Johor Bahru, 80100, Malaysia This paper reports the performance of x-ray generator and CT dosimetry in 4- and 16-slices Multi-Detector Computed Tomography (MDCT) scanners in axial mode scanning. 2 types of CT scanner were evaluated; 16-slices Siemen Somatom Emotion 16 and 4-slices Toshiba Asteion 4 Edition. The x-ray generator dose estimation of MDCT scanners performed under details technique parameters (kVp, mAs and exposure time) had been assessed using multi-function detector (Raysafe Unfors), TLD-100™ and nanoDot™ OSLDs. The assessment of weighted CT Dose Index (CTDIw) is measured using 100 mm standard pencil beam ion chamber, TLD-100™ and nanoDot™ OSLDs, in a 160 mm diameter head and 320 mm diameter body cylindrical acrylic Polymethyl-Methacrylate (PMMA) phantom (160 mm length). CTDIw values were specified either in central axis or 10 mm from the 4 outer edge of the phantom. The comparison between two sizes of phantoms made from measurements of the CTDIw in two types of CT scanners. The weighted CTDIs (CTDIw) were calculated and CT x-ray generator performance were observed. The results using three different type of detectors were examined and compared. The deviation accuracy of the tube voltage lied in between ±5 kV or ±5% whichever is greater, whereas the accuracy of exposure time and coefficient of linearity (mAs) lied in between ±10%. The radiation dose (CTDIw) to dose under exceptional CT scanning condition during axial modes were observed to meet the manufacturer guideline (<±20%). The implement CT dosimetry steps ensured the patient safety and can reduce future risk if an estimated dose value is inappropriately above the relevant threshold for any routine CT examination. Contact author: Ratna Suffhiyanni Omar; [email protected] Acknowledgement: This work was supported by the Ministry of Higher Education Malaysia and Universiti Teknologi Malaysia through UTM Zamalah Scholarship and Research University Grant Scheme (No. 17H79 and 03G72). Keywords: MDCT, CTDI, PMMA phantom

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ID #20: Elemental Evaluation of Urban Road Dirt via a Number of Analytical Techniques

Abdullah Alsubaie1,2*, L Alsulaiti3, Eman Daar1,4, Abdullah N. Al-Dabbous5,

Mariem Chamakh4, Maisarah Jaafar6, DA Bradley1,7 1Department of Physics, University of Surrey, Guildford GU2 XH, UK

2Department of Physics, College of Education and Science – Al Khurma, Taif University, Saudi Arabia 3 Department of Mathematics, Statistics and Physics Qatar University, Qatar

4 Department of Physics, The University of Jordan, Amman, Jordan 5Crises Decision Support Program, Environment and Life Sciences Research Center, Kuwait Institute for

Scientific Research, P.O. Box 24885, 13109, Safat, Kuwait 6 school of marine and environmental sciences,Universiti Malaysia Terengganu, 21030 Kuala Nerus,

Terengganu. 7Sunway University, Centre for Biomedical Physics, Jalan Universiti, 46150, PJ, Malaysia

*Corresponding author: [email protected] Abstract Worldwide, toxicological consequences are arising from vehicular contributions to

environmental pollution. Herein, elemental monitoring has been conducted of road dirt via a

number of analytical techniques, sampling being made along the busy campus roads of

universities/research institutes in Guildford, Riyadh, Kuwait City, Doha and Kuala Lumpur.

Using ICP-OES and ICPMS techniques, absolute values have been determined for Ti, Mn,

Co, Zr, Mo, Ba, Tl, V, Rd, Cu, Zn, Ni, Cr, Cd, As and Hg, while an SEM/EDX technique has

provided weight % values. Results are compared, both qualitatively and quantitatively. Al,

Fe, Mg, and Si have been found to be the most prominent elements in road samples,

particularly in respect of the Gulf countries and are in agreement with values observed in

previous work by the same group, use being made of XRF, SEM/EDX, ICP-MS and ICP-

OES. Furthermore, Mg, Ti, V, Cu, Zn, Ni, Cr and Ba have been observed throughout the

different climates, albeit at lower concentrations (minimum to maximum concentrations),

with particle sizes of the order of 0.5 micron. In addition, elemental presence is seen to be

influenced by climatic conditions as well as vehicle engine size. In conclusion, the various

techniques offer complementary information on vehicular emission elemental concentrations

in urban environments. Keywords: Road-dirt,/SEM EDX, ICP-MS and ICP-OES spectrometry. Highlights:

• Metal element concentrations in road dust samples investigated. • Results from SEM/EDX,ICP-MSandICP-OEScompared. • Elevated levels found, although less so in Malaysian and UK road dirt. • The concentrations of Mg show greater elevations in several Gulf locations.

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ID #31: Accuracy of Standardized Uptake Value Measurements in metastatic lesion for 99mTc-HMDP bone SPECT/CT Khairul Nizam Jaafar1 and Syahir Mansor1,2

1Nuclear Medicine Unit, Advanced Medical and Dental Institute, Universiti Sains Malaysia, 13200 Kepala Batas, Penang, Malaysia 2Oncological and Radiological Science Cluster, Advanced Medical and Dental Institute, SAINS@BERTAM Universiti Sains Malaysia, 13200 Kepala Batas, Penang, Malaysia

Advance development of iterative image reconstruction enables absolute quantification of SPECT/CT studies by incorporating compensation for collimator-detector response, attenuation, and scatter into the reconstruction process. The aim of this study is to assess its quantitative accuracy for potential clinical 99mTc-HMDP SPECT/CT application in the metastatic bone lesion. Uniform Jaszczak phantom equipped with six fillable spheres was filled with an activity ratio of 10 to 1 for sphere and background respectively and acquired on a SPECT/CT gamma camera (Discovery 670; GE Healthcare). Subsequently, volume-of-interest (VOI) of each sphere was drawn on SPECT using various methods on CT images. In addition to that, retrospective data of patient who underwent bone scan was acquired. Various VOIs were drawn on the metastatic lesion in the spine, rib while normal spine and lung as a reference for the normal region. The convergence of activity concentration was dependent on iteration number and application of post filtering. SUVmean metric shows an underestimation about 40% from the actual SUV while SUVmax shows and overestimation about 20% for the largest diameter sphere. The reduction of bias as much as -20% and -1.5% for SUV0.6max and SUV0.75max respectively. Patient study results were consistent with the phantom validation.

Absolute SPECT/CT quantification of bone metastatic lesion studies using 99mTc-HMDP seems feasible with < 8% deviation (19.7 mm diameter sphere) when using SUV0.75max as a metric, and sufficient iteration was used. However, with irregularities shape of metastatic lesions, the quantification evaluation should be further validated. Contact author: Syahir Mansor; [email protected] Acknowledgment: This study was supported by Universiti Sains Malaysia (USM), Short Term Grant 304/CIPPT/6315160. Keywords: SPECT/CT, SUV, quantitative, 99mTc-HMDP, phantom

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ID #31: Characterisation of photon counting cadmium zinc telluride (CZT) detector for preclinical imaging.

K. Hameed1, R. Zainon 1, M.Tamal2. 1Oncological and Radiological Sciences Cluster, Advanced Medical and Dental Institute, Universiti Sains Malaysia, SAINS@BERTAM, 13200 Kepala Batas, Pulau Pinang, Malaysia, 2Department of Biomedical Engineering, Imam AbdulRahman Bin Faisal University, Dammam, Eastern Province, 1982-31441, Kingdom of Saudi Arabia. The photon counting Cadmium Zinc Telluride (CZT) detector was characterized and its

performance has been evaluated for preclinical imaging. The CZT is a semiconductor detector that has photon counting capability with high resolution which can detect photon at a very low energy. The detector used is a part of MXA-128 linear detector system, with 128 pixelated detectors with a crystal dimension of 16.7 x 18.6 x 7.6 mm3, pixel size 0.9 x 0.9 mm2 and a pixel space of 0.1 mm. Each pixel array consists of 16 pixels/detector that contains a high voltage module with ranges from 0 to 1000 V, a read out module, and a linear array digital base board. It has four such separate modules with 32 channels each, which are configured using channel parameters and the data is readout through serial mode. It is a 16-bit system that records the photons in five different energy bins with ranges between 20 to 160 keV, it was integrated with a Phywe XRD X-ray tube with a maximum output power 35 kVp at 1.0 mA to scan the water phantom of different thickness with ranges from 28.5 mm to 67 mm, overall results shows that the CZT detector was highly sensitive even at small thickness variation compared to conventional CMOS X-ray detector, the inverse relation between the pixel counts versus Thickness were obtained. The study shows that the CZT detector can permit reliable detection in small thickness variation which can further need to investigate detector capabilities for spectroscopic imaging. Kamran Hameed; [email protected] Keywords: Cadmium Zinc Telluride (CZT), photon counting detector, energy bin, spectroscopic imaging and count rate.

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ID #34: Estimation of absorbed dose to lungs and heart in pediatric chest x-ray examination at different tube voltages: Phantom study

Inayatullah Shah Sayed1, Nurul Hazwani Md Jamal1, Waliullah Shah Syed2

1Department of Diagnostic Imaging and Radiotherapy, Kulliyyah of Allied Health Sciences, International Islamic University Malaysia, Jalan Sultan Ahmad Shah, Bandar Indera Mahkota, 25200 Kuantan, Pahang, Malaysia; 2School of Health Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kuban Kerian, Kota Bharu, Kelantan, Malaysia Children have a greater risk of developing lifetime cancer and other biological effects from ionizing radiation exposure, than adults. The aim of this study was to measure the absorbed dose received by lungs and heart in pediatric chest x-ray examination by using nanoDot optically stimulated luminescent dosimeter (OSLD). The x-ray system, Siemens Multix Top was used. A pediatric phantom developed by using beeswax and polyurethane foam was exposed at 50, 52 55, 57 and 60 kVp, with fixed tube current (3 mAs), which is normally used in pediatric clinical chest x-ray examinations. The nanodot OSLDs were placed in different parts in the thorax of the phantom according to the position of organs in the chest area, which are lungs and heart. For lungs, absorbed dose measurement nanoDot OSLDs were placed in the apex and base at three different depths. The phantom was exposed three times for each kVp value, and the absorbed doses were measured in mGy. The findings show that the measured absorbed dose to the heart increased with the increase in kVp. Overall, a 22% increase in absorbed dose to heart was recorded. And a 29% increase in lungs absorbed dose with the increase in kVp was recorded. In addition, absorbed dose to the base of left and right lungs was recorded higher up to 9% as compared to the apex of lungs. However, the exit-dose of lungs reduced by 20%. In conclusion, the absorbed dosage increases with exposure, while the absorbed dose decreases with depth. It is necessary for the radiographer to select an appropriate exposure setting based on the physical characteristics of the pediatric patient. Contact author: Presenting Author; [email protected] Acknowledgement: The authors would like to acknowledge the Department of Diagnostic Imaging and Radiotherapy, Kulliyyah of Allied Health Sciences, International Islamic University Malaysia (IIUM) for providing the facilities and equipment to carry out the study. This research is supported by the International Islamic University Malaysia under the Research Initiative Grant Scheme, RIGS #16-302-0466. Keywords: absorbed dose, chest X-ray, pediatrics, phantom, OSLD

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ID #35: Scattered radiation dose to caregivers’ in plain radiography: A case study

Inayatullah Shah Sayed1, Nurfadhilah Hanani Yusri1 1Department of Diagnostic Imaging and Radiotherapy, Kulliyyah of Allied Health Sciences, International Islamic University Malaysia, Jalan Sultan Ahmad Shah, Bandar Indera Mahkota, 25200 Kuantan, Pahang, Malaysia. In radiography it is imperative to protect patients and their caregivers from adverse effects of x- radiation when they undergo diagnostic procedures. However, in certain circumstances some radiation practitioners ignore radiation protection measures that should be practiced during x-ray examinations and allow the next-in-line patient and caregiver to wait behind x-ray lead barrier inside the radiography room till the earlier patient’s examination is complete. The purpose of this case study was to measure scattered radiation dose at six different heights in the x-ray room at specific positions that might be received by patient’s caregiver. Siemens Multix Top x-ray system was used. Anthropomorphic phantom Kyoto Kagaku Phantom PBU-50 (torso) was scanned by positioning supine on examination table for anteroposterior (AP) lumbar projection. Optically stimulated luminescent (OSL) dosimeters were fixed on a wooden stick at 120, 130, 140, 150, 160 and 170 cm heights with respect to the floor. The stick was fixed in such a way to stand vertically behind the x-ray lead barrier at 2.5 meters distance from the x-ray tube. The phantom was exposed by selecting tube voltages of 68, 79 and 90 kVp at a constant tube current, 32 mAs fixing a 100 cm source to image distance (SID). Results showed that scatter radiation doses measured at different heights were different for each exposure. The highest scattered radiation dose measured was 0.0064 mGy and 0.0042 mGy at 130 cm height for 79 kVp and 90 kVp exposures, respectively. It is concluded that the measured scattered radiation doses were within the acceptable dose limits as recommended in ICRP Publication 105 for patient comforter. Nonetheless, the malpractice should not be ignored because it exposes the individual to unnecessary radiation. Contact author: Presenting Author; [email protected] Acknowledgement: The authors would like to acknowledge the Department of Diagnostic Imaging and Radiotherapy, Kulliyyah of Allied Health Sciences, International Islamic University Malaysia (IIUM) for providing the facilities and equipment to carry out the study. This research is supported by the International Islamic University Malaysia under the Research Initiative Grant Scheme, RIGS #16-302-0466. Keywords: radiation protection, scattered radiation, plain radiography, OSLD

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ID #37: Radiation dose and Size Specific Dose Estimate from CT Pulmonary Angiography examinations

H H Harun1, M K A Karim1, N A Muhammad1, A Sabarudin2, S C Muniandy3 1Department of Physics, Faculty of Science, Universiti Putra Malaysia 43400 Serdang, Selangor, Malaysia; 2Department of Diagnostic & Applied Health Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz,50300 Kuala Lumpur, Malaysia; 3Department of Radiology, Hospital Kuala Lumpur, Jalan Pahang, 50586 Kuala Lumpur, Malaysia The number of Computed Tomography (CT) scan examinations has increased gradually owing to its advantages in providing high contrast diagnostic images. Despite continuous demand of the examination, the public and radiology personnel towards CT radiation dose is remains a concern. The purpose of this study is to evaluate radiation exposure for adult patients undergoing CT Pulmonary Angiography (CTPA) examinations based on the size-specific dose estimate (SSDE) and volume CT Dose Index (CTDIvol). We perform a retrospective study comprised of 30 patients (with age in year old range from 18 – 50 y/o) undergoing CTPA examinations. Scanning parameter data and radiation dose measures included diameter of antero-posterior and lateral, tube potential, tube current and CTDIvol. SSDE value were obtained from two type of calculations technique, AAPM report 204 recommendation and CT EXPO (Ver 2.3.1, Germany) software. The ratio of SSDE to CTDIvol was 1.63 and 1.41 for ≤25 cm effective diameter (n= 12) and ˃25 cm effective diameter (n = 18), respectively. The mean SSDE value were 13.49±6.09 mGy (p<0.001) and 14.40±6.38 mGy (p<0.001) estimated from AAPM recommendation and CT EXPO calculation, respectively. Both values were higher than CTDIvol from consoles indicate the patient’s f-size was larger than 1.0. In conclusion, we established different approach of determining radiation dose based on patient size and composition in order to further standardization of scanning protocols and staff training. Contact author: H H Harun; [email protected] Acknowledgement: The authors wish to acknowledge the support from Geran Putra IPM of Universiti Putra Malaysia with project no. GP/IPM/9619800 and Radiology staffs from Hosiptal Kuala Lumpur Keywords: Computed Tomography, SSDE, CT Pulmonary Angiography.

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ID #38: Cumulative Effective Dose in Adult Patients Population Undergoing Repeated or Multiple Head CT Scanning Mohd Amirul Azrie Mohd Roslee1, Ibrahim Lutfi Shuaib1, Ahmad Fakharuddin Mohd Napi2, Mohd Amir Syahmi Mat Razali1, Noor Diyana Osman1

1Advanced Medical and Dental Institute, Universiti Sains Malaysia, Kepala Batas, Penang, 13200, Malaysia; 2Department of Radiology, Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, 11800, Malaysia

The computed tomography (CT) scan is the most frequently used in diagnostic imaging. The current concern is related low radiation dose to patients and the potential radiation-related health effects due to multiple CT exposures. This study was aimed to evaluate cumulative organ dose received from multiple exposures in adult patients underwent CT head examination. The retrospective dose survey was performed at AMDI,USM and HUSM. A total of 202 adult patients had multiple exposures selected. The organ doses were estimated using CT ImPACT program. From the survey, most of the patients received 3 times head CT examinations. The highest organ dose was observed at lens with the value of 7.125 mSv for 13 exposures followed bythyroid with values of 7.48 mSv. Based on ICRP recommendation, the highest mean value of 7.48 mSv received by thyroid was considered atlow risk and within the range of 0.1-8 % below 100 mSv. Furthermore, organ dose received by lens was at low risk of cataract. However the increasing of multiple exposure will lead to dose contribution (p-value = 0.01). Moreover, the absorbed dose of the lens received after 4 exposures exceeded the rangeof 2 Gy of cataract risk with the M =242.05, p= 0.01.Besides, the mean cumulative effective dose by simple and CT ImPACT calculation were 32.1 mSv and 43.8 mSv (p-value = 0.01). The selection of effective dose calculation is important for an accurate outcome and dose received after multiple exposureson the same patients should be limited.

Contact author: Mohd Amirul Azrie Mohd Roslee; [email protected] Acknowledgement:The authors would like to thank all staff at Imaging Unit of AMDI and HUSM Kubang Kerian for their help and support throughout this work. We would also like to express our deep gratitude to Medical Dosimetry Group, Centre for Radiation, Chemical and Environmental Hazards (CRCE), Public Health England (PHE) for their data sharing related to this work. Keywords: Cumulative organ dose, Effective dose, Multiple CT exposure

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ID #42: Dose Optimisation in Paediatric CT Examination: Assessment on Current Scanning Protocols Associated with Radiation Dose Received Muhammad Kabir Abdulkadir1,2, Nur Atikah Yusra Mat Rahim3, Nur Syazwani Mazlan3, Norfataha Mohd Daud4, Noor Diyana Osman1 1Advanced Medical and Dental Institute, Universiti Sains Malaysia, Kepala Batas, Penang, 13200, Malaysia; 2Department of Medical Radiography, Faculty of Basic Medical Sciences, University of Ilorin, 240213, Nigeria; 3School of Health Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, 11800, Malaysia; 4Department of Radiology, Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, 11800, Malaysia Request for paediatric CT imaging has been increasing recently, to assess the associated potential risk and possibly identify need to modify the current practice, assessment of current paediatric protocols is of crucial importance. The aim of this study was to optimize the current practice through investigation of the radiation dose and existing routine acquisition protocols of paediatric CT imaging for head and abdomen examination at HUSM, Kelantan, Malaysia. A total of 150 CT paediatric (0-12 years) examinations (85 brains CT and 65 abdominal CT) were retrospectively collected from PACS and analyzed. Dose estimates in volumetric dose index (CTDIvol) and dose length product (DLP) and combination of exposure parameters kV, mAs, pitch, scan length and acquisition time currently in use for paediatric imaging were evaluated. Third quartile of our dose values were then compared with international standards and other countries. Estimated dose values in CTDIvol (mGy) and DLP (mGy.cm) for head and abdominal CT scans with respect to the age groups are 0-3 years (32/494 and 7/194), 4-6 years (63/1087 and 9/319), 7-9 years (59/1258 and 9.5/397), 10-12years (118/2215 and 13/498) respectively. Tube voltage selection was ranged from 100-120 kV for all groups except head scans in group 4 that used a constant 120 kV. Applied mAs vary and increases from group 1- 4 and ranges from 100-410 mAs for head scans and 35-100 mAs for abdominal scans. In this study, dose received from paediatric head CT scans were above the recommended levels. This is mainly due to selected acquisition parameters and hence, need for optimization of current protocols. Contact author: Muhammad Kabir Abdulkadir; [email protected] Keywords: Computed Tomography, Paediatric, Dose Optimization

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ID #44: Scatter cloud radiation in fluoroscopy-guided interventional (FGI)

room Asmah Bohari1, Suhairul Hashim1,2 and Siti Norsyafiqah Mohd

Mustafa3

1Department of Physics, Faculty of Science, Universiti Teknologi Malaysia, 81310 UTM Skudai, Johor, Malaysia; 2Centre for Sustainable Nanomaterials (CSNano), Ibnu Sina Institute for Scientific and Industrial Research (ISI-SIR), Universiti Teknologi Malaysia, 81310 UTM Skudai, Johor, Malaysia; 3Department of Radiology, Institut Kanser Negara, 62250 Putrajaya, Wilayah Persekutuan Putrajaya, Malaysia

Fluoroscopic imaging generates radiation fields that are unevenly scattered throughout the fluoroscopy-guided interventional (FGI) room. We wanted to quantify the radiation dose scattered at various locations during FGI procedures for clinical use. Digital subtraction imaging (Philips Allura Xper FD20/20, Philips Healthcare) of the abdomen was a performed-on Sawbones torso in standard anteroposterior (AP), left anterior oblique 45 (LAO45), left anterior oblique 90 (LAO90) and right anterior oblique 45 (RAO45) projection. Radiation exposure was monitored using optically stimulated luminescence dosimeter (OSLD). OSLD were placed on long pipe with height 100 cm from the floor. The OSLDs were readout using microStar reader system (Landauer, Inc.). With AP imaging, the radiation fields have symmetric bell shape, with maximal exposure perpendicular to patient table at the level of the gantry. Peak level at 75 cm from the source emitter were 5 times higher than the inverse square law. Maximal radiation exposure was measured in position 50 cm away and perpendicular to the table (13.32 mSv/h). When the gantry was rotated to LAO45 and LAO90, the radiation fields increased radiation doses to 28.65 and 22.99 mSv/h, respectively. Nevertheless, at the RAO45 was decreasing to 17.4 mSv/h. Minimal exposure is experienced along the axis of the table, decreasing with distance from the source (<0.33 mSv/h). Reproducible and observable scatter radiation is created during FGI procedure. Dose of radiation vary widely around the perimeter of the patient table and change according to imaging angles. Knowledge of the exposure levels may help in justifying the risks to staff. Contact author: [email protected] Acknowledgement: This work was supported by the Malaysian Ministry of Education and Universiti Teknologi Malaysia through the Research University Grant Scheme (No. 17H79 and 03G72). The study protocol was approved by the National Medical Research Register (NMRR-17-2092-34972) and Malaysian Ethical Research Committee (MREC(5)KKM/NIHSEC/P17-1524). Confidentiality of all personal details of the subjects was retained. Keywords: scatter cloud, OSLD, interventional

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ID #46: Small angle neutron scattering studies of dipalmitoylphosphatidylcholine-hyaluronic acid vesicle structural properties Irman Abdul Rahman1,2, Hur Munawar Kabir Mohd1, Faizal Mohamed1,2, Kenton P. Arkill3, Shahidan Radiman1,2, David A. Bradley4,5

1Nuclear Technology Research Centre, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, 43600 Bangi, Selangor, Malaysia; 2Centre for Frontier Sciences, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, 43600 Bangi, Selangor, Malaysia; 3School of Medicine, University of Nottingham, Nottingham, United Kingdom. 4Sunway University, School of Healthcare and Health Sciences, Centre for Biomedical Physics, No. 5, Jalan Universiti, Bandar Sunway, 47500 Petaling Jaya, Selangor, Malaysia 5Department of Physics, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford, GU2 7XH, UK We investigated the structural property changes that dipalmitoylphosphatidylcholine (DPPC) vesicles underwent after addition of hyaluronic acid (HA) using small angle neutron scattering (SANS). The functionality and stability of DPPC-HA vesicles especially as synovial fluid bio-lubrication component correlates with their structural properties. Vesicles were studied through detailed SANS data analysis on the colloidal fractal aggregation process using dynamic light scattering (DLS) and SANS. SANS results demonstrated that both DPPC and DPPC-HA vesicles showed mass fractality properties that produces a slope between -1 and -3 in a log-log Q-I(Q) plot. The slope and knee features of the scattering curves of both vesicles indicate the vesicle structure and shape. Additionally, the DLS (size and polydispersity) results were also used to explain the colloidal behaviour of the vesicles systems and their aggregation process. Contact author: Irman Abdul Rahman; [email protected] Acknowledgement: This work was supported in part by the Royal Society and the Academy of Sciences Malaysia through Newton-Ungku Omar Fund (ST-2018-022) and UKM Research University Grant (GUP-2018-060). We also thank the High-flux Advanced Neutron Application Reactor (HANARO) in Korea Atomic Energy Research Institute (KAERI) for allowing us to use SANS instrument. Keywords: Lipid vesicle, hyaluronic acid, mass fractal, small angle neutron scattering

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ID #51: Mass attenuation coefficients of Rhizophora spp. particleboards incorporated with metal elements as shielding materials at 16.59-25.26 keV photons Siti Nor Azizah Abdullah1, Mohd Fahmi Mohd Yusof2, Norlaili Ahmad Kabir1, Rokiah Hashim3, Abd Aziz Tajuddin4

1School of Physics, Universiti Sains Malaysia, 11800 Penang, Malaysia; 2School of Health Sciences, Universiti Sains Malaysia, 16150 Kota Bharu, Kelantan, Malaysia; 3School of Industrial Technology, Universiti Sains Malaysia, 11800 Penang, Malaysia; 4Registrar, Albukhary International University The study focused on the fabrication and attenuation evaluation of Rhizophora spp. particleboards incorporated with metal elements as potential shielding materials for low energy photons. The Rhizophora spp. particleboards were fabricated at density of 1.0 g/cm3 and incorporated with BaSO4 and Bi2O3 at 5, 10 and 15% percentage levels. The mass attenuation coefficients of the particleboards were measured by using the x-ray fluorescent (XRF) photons between 16.59 and 25.26 keV energies. The results showed that the mass attenuation coefficients of the particleboards increased when higher percentage levels of metal elements were used. The particleboards incorporated with Bi2O3 showed significantly higher mass attenuation coefficients that the particleboards incorporated with BaSO4. A comparison to the XCOM values of the metal elements showed that the particleboards incorporated with the highest percentage of Bi2O3 showed the nearest mass attenuation coefficients to the BaSO4. The overall results indicated the possibilities of the fabrication of shielding materials from Rhizophora spp. particleboards for low energy photons. Contact author: Mohd Fahmi Mohd Yusof; [email protected] Acknowledgement: The authors would like to thank the financial aid of RUI Grant scheme no. 1001/PFIZIK/811345 by Universiti Sains Malaysia. Keywords: Rhizophora spp., shielding materials, mass attenuation coefficients

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ID #53: Effects of mobile phone radiation on certain hematological parameters

Bindhu Christopher1, M U Khandaker2, D A Bradley2 and P J Jojo1,3

1Department of Physics, Fatima Mata National College(Autonomous), Kollam-691001, India 2Centre for Biomedical Physics, School of Healthcare and Medical Sciences, Sunway University, 47500 Bandar Sunway, Selangor, Malaysia. 3Department of Applied Physics, The Papua New Guinea University of Technology, Lae, PNG

Abstract

Exorbitant chronic exposure to any sort of radiation is hazardous to human health. Apart from ionizing radiations, exposure to electromagnetic radiations from the use of mobile phones have become a matter of great concern, especially in the wake of extortionate use even by children. There are several myths related to the ill effects including carcinogenicity of the prolonged exposure continuously. The objective of this investigation was to find the effect on certain hematological parameters, namely platelet count, hemoglobin level, WBC count and the ESR level due to the prolonged mobile radiation through in vitro examination of human blood samples with exposure to mobile radiations. 1:3 case control methodology was adopted for the study. Blood samples were collected by clinicians from voluntary subjects for investigation. One sample was kept un-exposed while the other three samples were exposed to mobile microwave radiations for 60minutes continuously in identical and controlled conditions. The 4G hand phone had transmission frequency range 2.3 to 2.4 GHz including uplink and downlink. Hematological analyses were carried out for fresh samples immediately after collection. Analyses after one-hour exposure were carried out in the exposed as well as un-exposed samples to find their platelet count, hemoglobin level, WBC count and the ESR level. Experimental results show that there is significant change on hematological components. The exposed blood samples were found to have decrease in platelet count and ESR rate. WBC count was found to increase. Even though these observations are for laboratory conditions, with the tremendous growth in number of mobile phone users, the effects can be many fold especially in work places and cities through passive exposure. Keywords: Mobile phone radiation; 60 mins exposure; Human blood sample; In vitro study;

Hematological parameters

Contact author: M U Khandaker; [email protected]; PJ Jojo; [email protected]; B. Christopher; [email protected];

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ID #54: Adaptive region growing image segmentation algorithms for

Breast MRI Joe Arun Raja1, Nelson Kennedy Babu2

1Subbalakshmi Lakshmipathy College Science, Madurai, Tamilnadu, 625022, India; 2SMK Fomra Institute of Technology, Chennai, Tamilnadu, 603103, India Early detection and characterization of breast lesion are important for a better and effective treatment of breast cancer. In this paper, four different adaptive region growing image segmentation algorithms are compared. In fact, seed selection was a vital step in the success of region growing methods, so, better schemes for seed selection methods are proposed, namely, joint probabilistic seed selection (JPSS) and Generalised simulated annealing (GSA) based seed selection. The proposed region growing methods namely Fuzzy Region Growing (FRG) and Neutrosophic Region Growing (NRG) are integrated as JPSS-FRG and GSA-NRG frameworks. Another two methods are Scale Invariant Region growing (SiRG) and Fuzzy Neutrosophic Confidence Region growing (FNCRG). The results showed that FNCRG algorithm increases breast cancer detection rate on MRI breast images with the maximum of 93% is achieved. SiRG algorithm improves the true positive rate by 13% compared to existing methods. Further, GSA-NRG makes better segmentation accuracy by 9% and true positive rate by 12%. Also, JPSS-FRG algorithm enhances segmentation accuracy by 24% and improving the true positive rate by 24% compared to Region Growing-Cellular Neural Network (RG-CNN) and Seeded Region Growing-Particle swarm optimisation (SRG-PSO) methods respectively. Contact author: Joe Arun Raja; [email protected] Acknowledgement: - Keywords: Breast MRI, Fuzzy logic, Neutrosophic logic, Breast Cancer Image Biomarker, Region growing algorithm

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ID #57: Effect of Gamma Irradiation on Magnetic Gadolinium Oxide Nanoparticles Coated with Chitosan (Gd-CsNPs) as Contrast Agent in Magnetic Resonance Imaging Faizal Mohamed1, Irman Abdul Rahman1, Mohd Idzat Idris 1, David Andrew Bradley2,3, Muhammad Zul Azri Muhammad Jamil1, Nur Ratasha Alia Md. Rosli1, Marlida Md Nor1, Siti Norsyafiqah Mohd Mustafa4

1School of Applied Physics, Faculty Science & Technology, Universiti Kebangsaan Malaysia, Bangi, Selangor, 43600, Malaysia 2Department of Physics, University of Surrey, Guildford, Surrey GU2 7XH, United Kingdom 3Centre for Biomedical Physics, School of Healthcare and Medical Sciences, Sunway University, Petaling Jaya, Selangor, 47500, Malaysia 4Radiology Department, National Cancer Institute, Kementerian Kesihatan Malaysia, Putrajaya, 62250, Malaysia Gadolinium based activation-guided irradiation by X-ray (AGuIX) nanoparticle is a promising theranostic agent candidate in the biomedical field. However in reducing the risk of nephrogenic systemic fibrosis (NSF) currently faced by renal failure patients, the size of the nanoparticle is of importance in being small to be rapidly eliminated via the renal route. This study elucidates a gamma irradiation-reduction approach in synthesizing small gadolinium nanoparticles specifically chitosan coated gadolinium oxide nanoparticles (Gd-CsNPs). Chitosan was used as a natural stabilizer and coating agent whereas gadolinium (III) chloride hexahydrate (GdCl3.6H2O) was used as a precursor. The properties of the synthesized Gd-CsNPs were studied in term of molecular conformation, surface plasmon resonance and particle distribution via ultraviolet-visible spectroscopy (UV-Vis), transmission electron microscopy (TEM) and Fourier transform infrared spectroscopy (FTIR) characterization. Formation of two new UV-Vis peaks at 260 nm and 290 nm depicts the chemical changes of chitosan post gamma irradiation with visible surface plasmon resonance band correlating the reduction of particle size. Further analysis via TEM demonstrates that synthesized Gd-CsNPs had an average diameter size in the range of 30 - 45 nm post gamma irradiation, a reduction of size in comparison with control Gd-CsNPs of 120 nm particle size. Enhancement of T1 image obtained via magnetic resonance imaging (MRI) testing proved the capability of synthesized Gd-CsNPs as a contrast agent. Coherently, gamma irradiation-reduction method may be used in controlling the size of nanoparticle and potentially be applied in all major fields related to gadolinium nanoparticle coated with chitosan like biopolymer. Contact author: Faizal Mohamed; [email protected] Acknowledgement: The work was financially supported by University Research Grant (GUP-2016-015) and Fundamental Research Grant Scheme (FRGS/1/2017/STG02/UKM/02/8). The author expresses gratitude to the staffs of the National Cancer Institute and Universiti Kebangsaan Malaysia Centre of Research & Instrumentation Management (CRIM) for their assistance in the testing of sample via MRI and also the characterization of samples using UV-vis, FTIR and TEM. Keywords: gadolinium nanoparticle, gamma irradiation-reduction method, contrast agent

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ID #62: Occupational Exposure of the operator Eye Lens in digital coronary angiography and interventions

Esam Mattar1, Amna J. Al-Jabri2, K. Alsafi3, A. Sulieman4, I.I. Suliman5,6,*

1Department of Radiological Sciences, College of Applied Medical Sciences, King Saud University, P.O Box 10219 Riyadh 11433, Saudi Arabia 2Department of Radiology and Molecular Imaging, Medical Physics Section, College of Medicine & Health Sciences, Sultan Qaboos University, P.O. Box 35, Al-Khod,123, Oman 3Department of Radiology, Medical Physics Unit; King Abdul Aziz University; P.O. Box 80215, Jeddah 21589, Kingdom of Saudi Arabia 4Prince Sattam bin Abdulaziz University, College of Applied Medical Sciences, Radiology and Medical Imaging Department, Alkharj, Kingdom of Saudi Arabia 5Al Imam Mohammad Ibn Saud Islamic University (IMSIU), College of Science, Physics Department, Committee on Radiation and Environmental Pollution Protection,, Riyadh 11642, Saudi Arabia 6Sudan Atomic Energy Commission, Radiation Safety Institute, P.O. Box 3001, Khartoum, Sudan Patient and staffs in interventional cardiology receive high doses that often exceed the threshold for tissue reactions. Radiation dose reduction in these procedures was therefore become a universal goal. The aim of this study is determination of eye lens dose to operator during cardiac angiography (CA) and percutaneous coronary interventions (PI). Air kerma-area product (PKA) was extracted from DICOM header concerning 250 patients who underwent CA and PCI procedures. Procedures were performed using biplane digital fluoroscopy system with flat-panel detectors. kerma-area product to eye lens dose conversion coefficients derived from literature were used to retrospectively estimate operator eye lens doses to 8 cardiologist who performed on average 20-40 IC procedures each during three month period. Based on literature review, PKA to eye lens dose conversion coefficients ranged from 0.8 to 2.2 µSv.Gy-1cm-2 (Median: 1 µSv.Gy-1cm-2). Only two cardiologists were observed using eye lens glasses and thyroid gland radiation protection tools. The Occupational exposure dose reduction factors were applied to obtain corrected eye lens dose levels. The estimated operator eye lens doses ranged from: 45.3 to 73.0 µSv per procedures in CA and from: 92.9 to 207.8 µSv per procedures in PCI. These doses are comparable to those presented in the literature and are very close estimated annual effective dose limit. These results provide a starting data point for institutional evaluation of operator eye lens doses in interventional cardiology for optimization radiation protection of the staff in interventional cardiology.

Contact author: Ibrahim I. Suliman; [email protected];

Acknowledgement: Occupational exposure, operator eye lens dose, interventional cardiology, radiation protection.

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ID #70: A STUDY ON THE EFFECT OF VARIOUS OBJECTS’ ANGULATION FROM CENTRAL LOCATION ON IMAGE DISPLACEMENT DUE TO X-RAY BEAM DIVERGENCE (IMAGE TECHNICAL EVALUATION)

ZAFRI AZRAN ABDUL MAJID1, SITI AISYAH MUNIRAH BINTI BOHANG1, MOHD

SYAHRIMAN MOHD AZMI2

1DEPARTMENT OF DIAGNOSTIC IMAGING AND RADIOTHERAPY, KULLIYYAH OF ALLIED HEALTH SCIENCES, INTERNATIONAL ISLAMIC UNIVERSITY MALAYSIA, JLN SULTAN AHMAD SHAH BADER INDERA MAHKOTA 25200 KUANTAN, PAHANG, MALAYSIA

2DEPARTMENT OF PHYSICS, FACULTY OF SCIENCE AND MATHEMATICS, UNIVERSITI PENDIDIKAN SULTAN IDRIS 35900 TANJONG MALIM, PERAK, MALAYSIA Introduction: X-ray machine tube produced x-ray with beam divergence property. Manipulation of object within the region of x-ray beam divergence caused image displacement effect on radiograph. Pauzi et al. (2014) proved the correlation between x-ray beam divergence and image displacement effect by using multi-parameter double holes contrast-detail phantom (MDHCD). However, there were limited research studies exhibited effects of various target objects’ angulations from central location toward image displacement effect. An image technical evaluation will be used in this study by attempted to demonstrate effects of various target objects’ angulations from central location on image displacement due to x-rays beam divergence. Method: This experimental study was conducted in Radiography Lab., IIUM by using angulation distance marker phantom (ADMP). ADMP was used to confirm image displacement effect and its associated factors such as objects’ angulation from central location (CL), object to image receptor distance (OID) and distance of markers from focal point. The study was conducted by exposing phantom with x-ray and associated factors involved were manipulated. Image was analyzed by using ImageJ software to measure distance and angular image displacement. Those measurements were also theoretically calculated by using mathematical equations and it was compared with actual measurements to determine accuracy of the result. Result and discussion: Distance of image displacement (DID) decreased (2.4, 2.1, 1.9) mm with increasing objects’ angulation from CL (30º, 45º, 60º) respectively. However, increases in objects’ angulation from CL led to an increment in the value of angular image displacement (AID) which was 1.79º, 3.16º, 5.40º respectively. There is no significant different in actual and theoretical values of image displacement effect produced. Besides, increasing angulation of object from CL reduced length of markers depicted on radiograph which were 22.6 mm, 18.4 mm and 13.0 mm respectively. OID and distance of markers from focal point had direct relationship with both DID and AID. Conclusion: In conclusion, manipulation of various objects’ angulation from CL within boundary x-ray beam divergence resulted in image displacement effects. Increased in objects’ angulation from CL caused more deviation of marker from control and created larger AID. Recorded length of markers also reduced. ADMP was useful as a quality control (QC) phantom to evaluate image displacement effect and it can be commercialized since its materials were widely available in market. Contact author: : [email protected] KEYWORDS: X-ray beam divergence, Distance of image displacement (DID), Angular image displacement (AID), Objects’ angulation from central location (CL)

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Clinical Oncology

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CASEREPORT3

ID#23:Peritoneal-pleuralLeaksDemonstratedbyPeritonealScintigraphy

DRMOHAMMADFITRIBINKHALIL

P-IPM0022/16

MMedNuclearMedicine

PhaseII AdvancedMedicalandDentalInstitute(AMDI) UniversitiSainsMalaysia(USM)

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Peritoneal-pleural Leaks Demonstrated by Peritoneal Scintigraphy Introduction

Continuous ambulatory peritoneal dialysis (CAPD) is widely used for the long

term management of end stage renal failure since the year 1976 (1). It is mainly used for

patients who are unable or unwilling to undergo haemodialysis or renal transplant,

patients with cardiovascular disease (mainly heart failure), old patient, those who are at

risk of adverse effect of systemic heparin, severe hypertension and those who have

exhausted their vascular access. The goals of peritoneal dialysis are removing toxic

substances and metabolic wastes, reverse the symptom of uraemia, re-establish normal

fluid and electrolyte balance and maintaining a positive nitrogen balance. Although it

offers several advantages over haemodialysis, there have been several recognized

complications. As it is mainly a long term form of usage, it requires intact anatomical

integrity of the peritoneal cavity (2). As intraabdominal pressure increases due to the

instillation of intraperitoneal fluid, it predisposes the patient to leaks and herniation

through defects in the abdominal wall (3). Complication related to usage of peritoneal

dialysis such as pleural effusion (due to peritoneal-pleural communication), scrotal

swelling (peritoneal-scrotal communication), hernia incarceration and recurrent

peritonitis, which all leads to temporary switching to haemodialysis. Investigation that are

usually performed such as peritoneal scintigraphy, computerized tomography (CT scan)

and peritoneography with iodinated contrast. Case report

Twenty-three-year-old gentleman with known history of hypertension and end

stage renal failure for the past four years was on haemodialysis 3 times a week using

arteriovenous fistula. Unfortunately, it was infected and non-functioning for the past 3

months and he used perm catheter for haemodialysis as a temporary measure. Trial of

re-inventing the arteriovenous fistula failed after 4 attempts. Due to exhausted vascular

access, he was started on continuous ambulatory peritoneal dialysis. He was trained for

the continuous ambulatory peritoneal dialysis (CAPD) and discharged well.

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However, he developed gradual onset of shortness of breath associated with

cough and fever. Chest x-ray was done and revealed massive right pleural effusion (Figure 1). He was admitted and treated with antibiotics. CAPD was withheld and he

was switched to haemodialysis using a temporary internal jugular vein catheter. Pleural tapping was done and noted the glucose level of 18.3 mmol/L which is

almost similar to peritoneal fluid while his serum blood glucose was only 5.0 mmol/L.

A repeat chest x-ray was done a few days later showed resolution of right pleural effusion (Figure 2). He was referred to nuclear medicine team to rule out peritoneal-pleural leaks of the peritoneal fluids.

119 MBq of Tc-99m nanocolloid mixed with 2.0L of dialysate fluid was slowly

infused into the peritoneal cavity through Tenckhoff catheter (Figure 3). Dynamic

imaging of abdomen and lower part of thorax was acquired for 30 minutes. Static images of anterior, posterior and lateral of abdomen and thorax was acquired after

30 minutes and delayed 2 hours later.

The first 30 minutes images showed accumulation of tracer within the

peritoneal cavity (Figure 4). Static images at 30 minutes showed faint uptake of

tracer in the right hemithorax (Figure 5). Images at 2 hours showed more prominent uptake of tracer at right hemithorax (Figure 6). Otherwise there was no abnormal

tracer accumulation in the left thoracic cavity or elsewhere. These findings were

suggestive of peritoneal fluid leakage into the right thoracic cavity.

Continuous ambulatory peritoneal dialysis for this patient is further withhold till correction of the leakage done. Meanwhile he will continue haemodialysis.

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Figure 1. Chest x-ray showed massive right pleural effusion.

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Figure 2. Chest x-ray showed resolution of right pleural effusion. Figure 3. Tenckhoff catheter in situ.

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Figure 4. There is accumulation of tracer within the peritoneal cavity during the first 30 minutes of study.

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Figure 5. Static imaging - There is faint uptake of tracer in the right hemithorax at 30 minutes (red arrow). It is more prominent in the posterior view.

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Figure 6. Static imaging - There is more prominent uptake of tracer in the right hemithorax at 2 hours (red arrows).

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Discussion

One of the primary complicating factors affecting the long term use of CAPD is loss of the anatomic integrity of the peritoneal cavity (4). Although some of the

complication can be detected clinically, it is often necessary to confirm using diagnostic imaging.

Pleural effusion or hydrothorax is uncommon, but it is a well-recognized

complication of peritoneal dialysis. Typically patient may develop pleuritic chest pain and shortness of breath. It is caused by migration of fluid into the pleural space via

pleuroperitoneal fistula. The reported incidence of pleural effusion in CAPD patient is

about 1.6% (5). There is a predominance of right sided pleural effusion, as the defect

are usually right sided and congenital (6). Most of the cases happened within the first 30 days of starting the peritoneal dialysis and about 25% of them are asymptomatic

(7).

The diagnosis of hydrothorax requires a combination of biochemical and imaging

modalities. Pleural fluid biochemistry analysis will usually reveal a transudate with a high

glucose concentration. The pleural fluid glucose is affected by the dialysate composition,

and generally accepted that a glucose level of more than 16.5 mmol/L or greater than

the serum glucose level is consistent with hydrothorax (8).

Imaging modalities such as computerized tomography scan (CT scan) and

MRI are less frequently used compared to peritoneal scintigraphy. Peritoneal

scintigraphy has a sensitivity of approximately 50% (8). Radiotracer that are usually

used includes Tc-99m sulfur colloid, Tc-99m nanocolloid and Tc-99m macro-aggregated albumin (MAA) as they do not diffuse through peritoneal surfaces. These

radiopharmaceuticals will stay below the diaphragm unless there is a connection

such as pleural or scrotal communications (9). Conclusion

In conclusion, peritoneal scintigraphy is useful for the evaluation of pleural

effusion or hydrothorax in patient with continuous ambulatory peritoneal dialysis.

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References: 1. Popovich RP, Moncrief JW, Nolph KD, Ghods AJ, Twardowski ZJ, Pyle W. Continuous ambulatory peritoneal dialysis. Annals of Internal Medicine. 1978;88(4):449-56. 2. Kopecky RT, Frymoyer PA, Witanowski LS, Thomas FD. Complications of continuous ambulatory peritoneal dialysis: diagnostic value of peritoneal scintigraphy. American Journal of Kidney Diseases. 1987;10(2):123-32. 3. Tokmak H, Mudun A, Türkmen C, Şanli Y, Cantez S, Bozfakioğlu S. The role of peritoneal scintigraphy in the detection of continuous ambulatory peritoneal dialysis complications. Renal failure. 2006;28(8):709-13. 4. Perez-Fontan M, Selgas R, Miguel J, Pardo M, González J, Conesa J, et al. Rupture of hernial sac as cause of massive subcutaneous dialysate leak in CAPD: diagnostic value of peritoneography. Dialysis & transplantation. 1986;15(2):74-7. 5. Nomoto Y, Suga T, Nakajima K, Sakai H, Osawa G, Ota K, et al. Acute hydrothorax in continuous ambulatory peritoneal dialysis–a collaborative study of 161 centers. American journal of nephrology. 1989;9(5):363-7. 6. Chow KM, Szeto CC, Li PKT, editors. Review Articles: Management Options for Hydrothorax Complicating Peritoneal Dialysis. Seminars in dialysis; 2003: Wiley Online Library. 7. Bae EH, Kim CS, Choi JS, Kim SW. Pleural effusion in a peritoneal dialysis patient. Chonnam medical journal. 2011;47(1):43-4. 8. Cho Y, D'Intini V, Ranganathan D. Acute hydrothorax complicating peritoneal dialysis: a case report. Journal of medical case reports. 2010;4(1):355. 9. Ziessman HA, O'Malley JP, Thrall JH. Nuclear Medicine: The Requisites E- Book: Elsevier Health Sciences; 2013.

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ID #30: Ion beams for space radiation radiobiological effects studies Ming Tsuey Chew1, Andrew Nisbet2,3, Masao Suzuki4, Naruhiro Matsufuji5, Takeshi Murakami6, Bleddyn Jones7, Mayeen Khandaker1, David A Bradley1, 2

1Sunway University, School of Healthcare and Health Sciences, Centre for Biomedical Physics, No. 5, Jalan Universiti, Bandar Sunway, Selangor, Petaling Jaya, 47500 Selangor, Malaysia. 2Department of Physics, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford, GU2 7XH, UK. 3The Department of Medical Physics, Royal Surrey County Hospital, Egerton Road, Guildford, GU2 7XX, UK. 4Department of Basic Medical Sciences for Radiation Damages; National Institute of Radiological Sciences (NIRS), National Institutes for Quantum and Radiological Science and Technology, 4-9-1 Anagawa, Inage-ku, Chiba-shi, Chiba 263-8555, Japan. 5Radiation Effect Research Team, Department of Accelerator and Medical Physics, NIRS, Japan. 6Heavy-Ion Radiotherapy Promotion Unit & Department of Accelerator and Medical Physics, NIRS, Japan. 7Gray Laboratory, CRUK/MRC Oxford Centre, Old Road Campus Research Building, Roosevelt Drive, University of Oxford, OX3 7DQ, UK. Space radiation exposures to the heavier particles found in galactic cosmic rays (GCR) present a risk in manned space travel, most particularly to the central nervous system (CNS). GCR are made up of a mixture of multiple charged particles such as protons, 4He and 56Fe heavy ions. The most harmful to the CNS are the high charge and energy (HZE) particles, including 56Fe because of its significant contribution to GCR dose and its high LET (Friedberg and Copeland, 2011). These HZE can result in altered cognitive function, reduced motor function and behavioural changes and long term chronic brain disease. For present interests, note is made of the lack of data on the biological response of 56Fe ions. Ground based experiment can be used to infer the effects of the cosmic environment on cell survival, acknowledging that the response of tumour cells and healthy cells of other organs may be different thus limiting the accuracy of this inference. A mono-energetic beam of 56Fe ions was generated by the Heavy Ion Medical Accelerator, National Institute of Radiological Sciences, Chiba. Present data refer to use of Glioblastoma multiforme (GBM) cells which, in arising from the brain, may infer the effects of space radiation on the CNS. Moreover, given that some strains of GBM cell lines are low dose hypersensitive, the very low doses that are used herein to study space radiation could be relevant. The limitation is that they are not normal cells; hence, restrictions need to be applied when interpreting these results.

Keywords: Space radiation, radiobiological effects, 56Fe, galactic cosmic rays, GBM Reference: 1. Friedberg, W. and K. Copeland, Ionizing Radiation in Earth's Atmosphere and in

Space Near Earth. 2011. 32. Contact author: Chew Ming Tsuey; [email protected] Acknowledgement: We thank the engineering staff of HIMAC for their support in making ion beam irradiations and acknowledge the technical support and assistance of Drs CH Liu, M Wada and N Autsavapromporn. This work was partly supported by the International Open Laboratory for the travel grants to NIRS/HIMAC, Japan to perform the experiments. This research was funded by PARTNER FP7-215840-2/Marie Curie and the ion beams were sponsored by NIRS/HIMAC, Chiba, Japan

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ID #40: 68Ga-Prostate-Specific Membrane Antigen (PSMA) PET/CT, a superior modality in restaging of prostate adenocarcinoma. A case report. Muhammad Adib Abdul Onny1, Mohd Fahmi Shukur Ramli2, Lee Boon Nang2, Hazlin Hashim1

1. Nuclear Medicine Unit, Oncology & Radiological Sciences Cluster, Advanced Medical & Dental Institute,

Universiti Sains Malaysia, Bertam, Pulau.Pinang, 13200, Malaysia. 2. Department of Nuclear Medicine, Institut Kanser Negara, Putrajaya, 62250, Malaysia.

Prostate adenocarcinoma is among the ten most common malignancy among male in Malaysia with incidence of 6.6 per 1000001. Prostate-Specific Membrane Antigen (PSMA) is a cell surface protein which is overly expressed in metastatic prostate lesions and coupling of positron emitting agent such as 68Ga allows excellent imaging of these lesions. We present a case of a 75-year-old gentleman diagnosed with prostate adenocarcinoma, Gleason score 7(4+3). MRI pelvis showed bilateral local involvement with extracapsular extension and possible head of femur metastasis. However, bone scan was negative. He was started on anti-androgen therapy and a repeat bone scan after 3 years still showed no bone metastasis. However his serum PSA increased from 4.23ng/ml to 7.19ng/ml. 68Ga-PSMA PET/CT was performed which eventually showed extensive local disease and extensive bone metastasis. Most of the PSMA positive bone lesions showed no significant CT changes. In light of the imaging findings, patient was started on IM Lucrin with prednisolone. 68Ga-PSMA PET/CT has been shown to be sensitive in detecting metastatic lesion even in the setting of low PSA level. Various recent meta-analysis have shown that the sensitivity and specificity of 68Ga-PSMA PET/CT are 61-80% and 84-97% respectively with another large review reported detection rate of 79.5% in the setting of biochemical recurrence2,3,4. This particular case has shown the benefit of 68Ga-PSMA PET/CT in restaging of disease and assisting in the clinical management. In addition, the advent of theranostic approach allows 68Ga-PSMA PET/CT to be paired with beta-emitting agents for the treatment of bone pain, an option that could be considered in this patient. References 1. Azizah, Ab.M, Nor Saleha, I.T., Noor Hashimah, A., Asmah, Z.A., Mastulu, W. (2016).

Malaysian National Cancer Registry Report 2007-2011. 2. Lenzo, N., Meyrick, D. and Turner, J. (2018). Review of Gallium-68 PSMA PET/CT

Imaging in the Management of Prostate Cancer. Diagnostics, 8(1), p.16. 3. Perera, M., Papa, N., Christidis, D., Wetherell, D., Hofman, M., Murphy, D., Bolton, D. and

Lawrentschuk, N. (2016). Sensitivity, Specificity, and Predictors of Positive 68 Ga– Prostate-specific Membrane Antigen Positron Emission Tomography in Advanced Prostate Cancer: A Systematic Review and Meta-analysis. European Urology, 70(6), pp.926-937.

4. Udovicich, C., Perera, M., Hofman, M., Siva, S., Del Rio, A., Murphy, D. and Lawrentschuk, N. (2017). 68 Ga-prostate-specific membrane antigen-positron emission tomography/computed tomography in advanced prostate cancer: Current state and future trends. Prostate International, 5(4), pp.125-129.

5. Evans, J., Jethwa, K., Ost, P., Williams, S., Kwon, E., Lowe, V. and Davis, B. (2018). Prostate cancer–specific PET radiotracers: A review on the clinical utility in recurrent disease. Practical Radiation Oncology, 8(1), pp.28-39.

Contact Author Muhammad Adib Bin Abdul Onny; [email protected] / [email protected]

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Acknowledgment Our acknowledgment to the Director General of Health, Malaysia, Director of Institut Kanser Negara and Director of Advanced Medical & Dental Institute, Universiti Sains Malaysia. Keywords Prostate carcinoma, 68Ga-PSMA PET/CT, Prostate-Specific Membrane Antigen, prostate-specific antigen, PET/CT, Theranostics.

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ID #47: Comparison of standardized uptake value maximum (SUVmax) between metastastic and degenerative joint disease of the spine using bone scintigraphy with single photon emission computed tomography/ computed tomography (SPECT/CT) in prostate cancer Mohd Fazrin Mohd Rohani1,2, Hazlin Hashim2, Syed Ejaz Shamim1, Norazlina Mat Nawi1, Wan Fatihah Wan Sohaimi1 1Nuclear Medicine, Radiotherapy and Oncology Department, Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, 16150, Malaysia 2Nuclear Medicine Unit, Oncological and Radiological Sciences Cluster, Advanced Medical and

Dental Institute, Universiti Sains Malaysia, Bertam, Pulau Pinang, 13200, Malaysia Abstract: Qualitative interpretation in bone scan is often complicated by presence of degenerative joint disease (DJD) especially in the elderly (1,2). The aim of this study is to compare objectively 99mTc-methylene diphosphonate uptake between DJD and osseous metastases of the spine using semi-quantitative assessment with SPECT SUV (3). Bone scan with SPECT/CT using 99mTc-MDP were performed in 34 patients diagnosed with prostate carcinoma. SPECT/CT were performed based on our institutional standard guidelines (4). SUVmax based on body weight (5,6) of 238 normal vertebrae visualized in SPECT/CT were quantified as baseline. A total of 211 lesions in the spine were identified on bone scan. Lesions were characterized into DJD or bone metastases based on its morphology on low dose CT (7). Semi-quantitative evaluation using SUVmax were then performed on 89 DJD and 122 metastatic bone lesions. The mean SUVmax for normal vertebrae was 7.08 ± 1.97, 12.59 ± 9.01 for DJD and 36.64 ± 24.84 for bone metastases. The SUVmax of bone metastases were significantly greater than DJD (p value <0.05). To assess for diagnostic accuracy, receiver operating characteristics (ROC) curve was performed. The area under the curve (AUC) was found to be fairly high at 0.874 (95% CI: 0.826-0.921). The cut-off SUV value 19.04 gave a sensitivity of 73.8% and specificity of 85.4% in differentiating bone metastases from DJD. SPECT SUVmax was significantly higher in bone metastases than DJD. Semi-quantitative assessment with SUVmax can complement qualitative analysis. A cut-off SUVmax of 19.04 can be used to differentiate bone metastases from DJD.

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References: 1. Gerard J O’Sullivan FLC, Carmel G Cronin. Imaging of bone metastasis: An update.

World Journal of Radiology. 2015;7(8):202-11. 2. Saima Muzahir RJ, Glenn Liu, Lance T Hall, Alejandro Munoz Del Rio, Timothy

Perk, Christine Jaskowiak, Scott B Perlman. Differentiation of metastatic vs degenerative joint disease using semi-quantitative analysis with 18F-NaF PET/CT in castrate resistant prostate cancer patients. American Journal of Nuclear Medicine and Molecular Imaging. 2015;5(2):162-8.

3. Zafeirakis A. Scoring systems of quantitative bone scanning in prostate cancer: historical overview, current status and future perspectives. Hellenic Journal of Nuclear Medicine. 2014;17(2):136-44.

4. T. Van den Wyngaert KS, W. U. Kampen, T. Kuwert, W. van der Bruggen, H. K. Mohan, G. Gnanasegaran, R. Delgado-Bolton, W. A. Weber, M. Beheshti, W. Langsteger, F. Giammarile, F. M. Mottaghy, F. Paycha. The EANM practice guidelines for bone scintigraphy. European Journal of Nuclear Medicine and Molecular Imaging. 2016;43:1723-38.

5. Michal Cachovan AHV, Joachim Hornegger, Torsten Kuwert. Quantification of 99mTc-DPD concentration in the lumbar spine with SPECT/CT. European Journal of Nuclear Medicine and Molecular Imaging. 2013;3(45).

6. Tomohiro Kaneta MO, Hiromitsu Daisaki, Shintaro Nawata, Keisuke Yoshida, Tomio Inoue. SUV measurement of normal vertebrae using SPECT/CT with Tc-99m methylene diphosphonate. American Journal of Nuclear Medicine and Molecular Imaging. 2016;6(5):262-8.

7. Einat Even Sapir RHM, David C. Barnes, Christopher R. Pringle, Sian E. Iles, Michael J. Mitchell. Role of SPECT in differentiating malignant from benign lesions in the lower thoracic and lumbar vertebrae. Radiology. 1993;187(1):193-8.

Contact author: Mohd Fazrin Mohd Rohani; [email protected] Acknowledgement: The authors would like to thank all the staff of Nuclear Medicine, Radiotherapy and Oncology Department, Hospital Universiti Sains Malaysia for their support and dedication. Keywords: Bone scintigraphy, SPECT/CT, SPECT SUV, bone metastasis, prostate

cancer, 99mTc-MDP

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ID #56: Case Report - IORT in Pantai Hospital Kuala Lumpur

M.S.Ainina1, Yong Qian Ying1

1Pantai Hospital Kuala Lumpur, Bangsar, 59100, Malaysia Intraoperative Radiation Therapy (IORT) use low kV energy as it is done at tumour bed just after tumour was removed. IORT was introduced to treat breast, colon, spine and brain metastasis. There are two ways in using IORT for breast as it can be used alone (TARGIT- A) and act as a boost (TARGIT-B) that soon will be top up with external beam radiotherapy few weeks after done with the surgery. Pantai Hospital Kuala Lumpur (PHKL) already started with five cases of TARGIT-A IORT. It was successfully done by our OT team and physicist. Time taken for IORY procedure was depends on applicator size and dose prescribed by physicians. As dose prescribed by oncologist was 20Gy at 0mm from applicator surface, the irradiation time was controlled by applicator size only. Obviously, it took longer irradiation time for bigger applicator but for our presented case the biggest applicator size used was 4.5cm and the beam on time took less than 45 minutes. Contact author: M.S.Ainina; [email protected] Keywords: Intraoperative Radiation Therapy, Breast cancer, TARGIT-A

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ID #58: Bioactive glass: exploring its potentials use for treatments based on in vivo and in vitro studies

Haruna S. J1, Shahrul H1 and Fazliah SNMN2

1Oncological & Radiological Sciences Cluster, Advanced Medical and Dental Institute, Universiti Sains Malaysia, 13200 Kepala Batas, Penang, Malaysia; 2Craniofacial & Biomaterials Sciences Cluster, Advanced Medical and Dental Institute, Universiti Sains Malaysia, 13200 Kepala Batas, Penang, Malaysia Biomaterials received intense research interest over the last decade. One of the biomaterials that is extensively studied is the bioactive glass (BG). This paper aims to highlight various methods adopted to produce the BG, their characterisation and potential application in medical and dental fields. Systematic review based on BG as keyword retrieved from databases highlighted that manufacturing techniques commonly used to produce BG include melt-derived, melt-annealed, freeze-casting and sol-gel methods. BG composition was modified based on the gold standard 45S5® BG SiO2-CaO-NaO-P2O5 system by addition of different types of alkaline earth metal such as strontium, magnesium, zinc, cobalt and many others where each of these ions possessed specific function to aid bone regeneration, enzymatic function, antibacterial, healing and angiogenesis. BG exists as powder, pellet, tablets and three-dimensional (3D) structures with the addition of other polymeric materials such as gelatin, polycaprolactone, polylactic acid for enhanced mechanical and physical properties. Besides that, bioactive glass-based scaffolds can be further functionalised to achieve higher mechanical stability, particularly toughness, and to provide drug-delivery capability. In addition, synthetic and natural polymer-coatings are used to increase mechanical stability and serve as carrier matrix for the local release of growth factors or antibiotics to support bone tissue formation. BG has shown numerous biocompatibility capabilities towards various types of cells in vitro while in vivo studies showed no adverse effect and BG exhibited high angiogenesis which facilitate tissue repair. Taken together, bioactive glass displays high biocompatibility which show that it has potential to be explored further for medical and dental applications.

Contact author: [email protected] Presenting author: Haruna S Jallow Email of presenting author: [email protected] Keywords: bioactive glass, biomaterials, bone formation

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Cancer Cell Biology

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ID #54: Prenatal Ultrasound Induces Apoptotic Neurons and Glial Cells (AC) in

Rabbit Fetal Brain: A Biochemical analysis F. W. A. Zaiki1, S. M. Dom2

1 Kulliyyah of Allied Health Sciences, International Islamic University Malaysia, Kuantan, Pahang, 25200, Malaysia;2 Faculty of Health Sciences, Universiti Teknologi MARA, Puncak Alam, Selangor, 42300, Malaysia. Ultrasound wave propagates through tissues are absorbed and converted to heat. Findings in numerous studies utilizing the ultrasound exposure have also convinced the existence of ultrasound-induced apoptosis in the exposed cells. Hence, this current study was aimed to detect the apoptotic neurons and glial cells (AC) in the rabbit fetal brain resulting from the prenatal ultrasound exposure. The terminal dUTP nick end-labeling (TUNEL) assay staining by ApopTag® Plus Peroxidase In-Situ Apoptosis Detection Kit (S7101) from Millipore, USA was used. The effects of prenatal ultrasound to neurons and glial cells were analyzed by comparing the AC counts in the rabbit fetal cerebral cross section between the expose and control groups. At least 3 TUNEL stained slides were randomly examined from each subject making a total of N=102 (30 minutes exposure, n= 9; 60 minutes exposure, n= 9; 90 minutes exposure, n= 9; control, n= 7). The temperature increment was measured during the prenatal ultrasound exposure, which the maximum was 1.0, 1.8 and 3.3°C for 30, 60 and 90 minutes of exposure, respectively. Data was analyzed using SPSS version 21.0. The p-values were significant at all stages of gestation with all the p-values were less than 0.001 (p<0.001). The results suggested that there were significant differences in AC counts in all stages of gestation between groups of different exposure duration. The detection of the DNA fragmentation in TUNEL positive cell could serve as an evidence in suggesting the apoptosis was induced by the ultrasound exposure. Contact author: F. W. A. Zaiki; [email protected] Acknowledgement: The authors would like to acknowledge the Research Management Centre of International Islamic University Malaysia, Malaysia for the Research Initiative grant Scheme (RIGS) grant awarded (RIGS 16-300-0464) and Research Management Institute (RMI) of Universiti Teknologi MARA, Malaysia for the Research Intensive Faculty (RIF) grant awarded (600-RMI/DANA/5/3/RIF (229/2012). Keywords: prenatal, ultrasound, apoptotic, neuron, glial, rabbit, fetal, brain, biochemical, TUNEL.

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ID #13: HDR brachytherapy in reirradiation of local nasopharyngeal

recurrence Mohamed ait erraisse1, wissal hassani1, moulay ali youssoufi2, khalid

hassouni1

1Department of Radiotherapy, University Hospital Hassan II, Fes, 30003, Morocco; 2 Faculty of Sciences (LPHE, M-S), University Mohammed V, Rabat, 10010, Morocco;

Purpose: Nasopharyngeal carcinoma (NPC) is the most frequent cancer of head and neck in

North Africa and South East Asia. Reirradiation of local recurrence is limited by the dose

constraints. Brachytherapy alone or in combination with EBRT can be a good compromise.

The aim of this study was to determine the role of brachytherapy in safety reirradiation of

recurrent NPC. Material and Methods: This is a retrospective study of 8 patients with

nasopharyngeal cancer recurrence collected in the radiotherapy department of the University

hospital Hassan II in Fez between January 2014 and December 2017. Results: The average age

of our patients is 42 years old. the average time to onset of relapse is 29 months. All patients

received external radiation therapy at 70 Gy on macroscopic tumor volume (tumor and

lymphadenopathy) during initial irradiation with or without chemotherapy. relapse was

localized in 5 patients and associated with lymph node involvement in 3 patients. 2 patients

received exclusive high-dose-rate brachytherapy and 6 received external radiation radiotherapy

followed by brachytherapy. The total radiation dose EQD2 was 60 to 66 Gy. With an average

follow-up of 20 months, 37.5% of patients are alive and in complete remission. Conclusion:

Brachytherapy alone or after EBRT could play an important role in reirradiation of locally

recurrent NPC with acceptable toxicity. Contact author: Mohamed Ait Erraisse; [email protected] Keywords: nasopharynx, brachytherapy, reirradiation

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ID #25: Cytotoxic Effects of Low-Level Laser Irradiation on Human Breast Cancer MCF-7 Cells: In Vitro Study Husna Azdiyah Habita @ Habit1, Nursakinah Suardi1, Shahrom Mahmud1, Rabiatul Basria S.M.N Mydin2, Siti Khadijah Mohd Bakhori1 1School of Physics, Universiti Sains Malaysia, Pulau Pinang, 11800, Malaysia; 2Oncological and Radiological Sciences Cluster, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Penang, 13200, Malaysia Today, it was realized that laser therapy had the potential to replace the recent cancer treatments such as chemotherapy and radiotherapy as they have high potential to damage surrounding healthy cells although they are proven to be effective in reducing the size of tumours. This study focusing on low level laser therapy which is selectively kill cancer cells, as the light beam can directly expose to the targeted site while not affecting the normal cells. It is non-invasive due its energy densities are lower than other types of laser. The MCF-7 cells were plated to a density of 4 ×104 cells/well in 96-well plate and incubated for 24h. Then, the cells were treated with 532 nm laser at different power and dose. In Group 1, the laser power was 1 mW with different doses of 0.24 J cm-2 , 0.72 J cm- 2 , and 1.2 J cm-2 while the Group 2, the laser power was 15 mW with different dose of 3.6 J cm-2 , 10.8 J cm-2 , and 18 J cm-2 . In Group 3, the MCF-7 will be treated with 30 mW at doses of 7.2 J cm-2 , 21.6 J cm-2 and 36 J cm-2 . After that, the absorbance of treated MCF-7 cells were measured by Alamar Blue to determine the toxicity of laser exposure on the cells. 1 mW laser irradiation proved to be less efficient at lowest dose of 0.24 J cm-2 when the cell inhibits only 21 %. The cell viability reduced to 90 % after treated with the same power as the dose increases whereas the cells completely killed after treated with 15 mW and 30 mW. This study highlights the LLLT could become a promising therapy by providing localized therapies and improve patient quality of life. Contact author: Husna Azdiyah Binti Habita @ Habit; [email protected], Nursakinah Suardi; [email protected] Acknowledgement: The authors would like to thank Universiti Sains Malaysia (USM), Penang for the grant provided (203/PFIZIK/6711598), the staff of Oncology and Radiological Cluster, Advanced Medical and Dental Institute (AMDI) for their assistance and support of this research. Keywords: Laser, AuNPs, MCF-7 cell line

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ID #36: Specific inhibition of miR130a using CRISPR/Cas9 induces the proliferation and migration of non-small cell lung cancer cell line. Siti Razila Abdul Razak1, Nur Ainina Abdollah1, Nabil Izzatie Mohamad Safiai1, Muhammad Khairi Ahmad1, Kumitaa Theva Das2

1

Oncological and Radiological Sciences Cluster, Advanced Medical and Dental Institute, Kepala Batas,

Pulau Pinang, 13200, Malaysia; 2

Infectomics Cluster, Advanced Medical and Dental Institute, Kepala Batas, Pulau Pinang, 13200, Malaysia. Molecular alterations of microRNA (miRNA) such as miR130a, are frequently observed in regulation of many types of cancers, including the non-small cell lung cancer (NSCLC). However, the specific roles of miR130a in NSCLC has been poorly studied. In this study, we utilized a genome editing tool, clustered regularly interspaced short palindromic repeat (CRISPR)-Cas9, to identify specific target sites for the knockdown of miR130a. We further investigated the effects of the suppression in A549 NSCLC cell line to better understand the significance of miR130a in NSCLC. Briefly, 20 bp single-guided RNA sequences that targeted the stem loop, 3' and 5' sites of miR130a gene were cloned into lentiCRISPRv2. The cloned plasmids were transfected into A549 cell line and selection was performed using puromycin. Total RNA was extracted and mature level of miR130a-3p and miR130a-5p were quantified with real-time PCR. Proliferation and migration assays were also conducted. Our results showed that the CRISPR/Cas9 that targeted the 3’ site and stem loop of miR130a gene were able to significantly down-regulate the endogenous expression of mature miR130a-3p and 5p by two and three-fold respectively. No changes were observed when Cas9 targeted the 5’ site of the miR130a gene. The growth and migrations assays correlated with our real-time PCR analysis, in which suppression of miR130a-3p significantly increased the growth and migration of A549 cells. No significant changes were observed in cells with suppressed expression of miR130a-5p. Our encouraging results highlight the efficacy and specificity of CRISPR-Cas9 to knockdown miR130a, and suggest that inhibition of miR-130a-3p could play an important role in the regulation of NSCLC cancer.

Contact author: Siti Razila Abdul Razak, [email protected] Acknowledgement: This project is supported by USM Short Term Grant (304/CIPPT/6313203) and Fundamental Research Grant Scheme (203/CIPPT/6711505) Keywords: miR130a, non-small cell lung cancer, A459 proliferation, A549 scratch assay, A549 migration assay

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ID #39: Construction of Yeast Two-Hybrid (Y2H) Bait Vector for Screening of Selected Deubiquitinases (DUBs)-interacting Protein.

Nur Wahida Zulkifli1 and Nurulisa Zulkifle1

1Oncological and Radiological Sciences Cluster, Advanced Medical & Dental Institute, Universiti Sains Malaysia, Kepala Batas, Penang, 13200, Malaysia Over the past few years, deubiquitinases (DUBs) has emerged as promising new therapeutic targets in many diseases including cancer. Defining DUBs interaction landscape is very important in order to understand DUBs mechanism. Yeast two-hybrid (Y2H) is a yeast-based genetic assay that is commonly used to detect novel protein-protein interaction. In this work, Y2H bait vectors were constructed for screening of selected DUBs-interacting proteins. Total RNA was extracted from Human Embryonic Kidney (HEK293) cell line by using TRIzol. mRNA was isolated using Oligotex mRNA Mini Kit and cDNA library was constructed. Selected DUBs (e.g. OTUB1, OTUB2, and OTULIN) genes were amplified using Taq 2X Master Mix to produce PCR products of selected DUBs genes with dA overhangs at the 3’-end. The selected DUBs genes were directly ligated into the pCR 8/GW/TOPO vector using pCR 8/GW/TOPO TA Cloning Kit to get the entry clone. Then the recombinant TOPO-DUBs plasmids entry clones were transformed into NEB 5-α Competent E.coli cells and recombinant plasmids were purified by using QIAGEN Plasmid Mini Kit. The recombinant TOPO-DUBs plasmids were confirmed by colony PCR and DNA sequencing. LR recombination reaction was performed between recombinant TOPO-DUBs plasmid entry clone and pDEST32 yeast expression vector using Gateway LR Clonase II Enzyme Mix. The bait plasmids of pDEST32-DUBs were validated by colony PCR and DNA sequencing. Results showed that the selected DUBs were successfully cloned into pDEST32 vector and ready to be transfected into Saccharomyces cerevisiae strain MaV203. Currently, construction of Y2H prey vector using cDNA library are in progress. Upon completing the cDNA prey vector, the Y2H GAL4 system can be utilized to find selected DUBs-interacting proteins. Contact author: Nur Wahida Zulkifli; [email protected] Acknowledgement: This work is supported by the Government of Malaysia under grant FRGS/1/2014/SG05/USM/02/1. The scholarships to Nur Wahida Zulkifli are funded by MyBrain15 KPT. Keywords: Yeast Two-Hybrid (Y2H), Bait vector, Deubiquitinases (DUBs)

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ID #41: Generation of Indels for dual-specificity phosphatase 6 (DUSP6) gene suppression in colorectal cancer cell line via CRISPR-Cas9 system. 1Muhammad Khairi Ahmad, 1Nur Ainina Abdollah, 2Kumitaa Theva Das, 1Siti Razila Abdul Razak 1Oncological & Radiological Sciences Cluster, Advanced Medical & Dental Institute, Universiti Sains Malaysia, Bertam, 13200 Kepala Batas, Pulau Pinang, Malaysia. 2Infectomics Cluster, Advanced Medical & Dental Institute, Universiti Sains Malaysia, Bertam, 13200 Kepala Batas, Pulau Pinang, Malaysia. Abstract Dual-specificity phosphatase 6 (DUSP6) plays vital role as pro-oncogenic or tumour-suppressor in various types of cancers. It interacts with ERK1/2 via negative feedback regulation in MAPK pathway, which aberration is frequently observed in cancers. However, the specific role of DUSP6 in colorectal cancer (CRC) is poorly studied. Gene-editing system has long been used to study gene and carcinogenic pathway in cancer. However, the cost, time and practicality to design and establish the system to manipulate gene expression could limit the experimental process. The emergence of CRISPR-Cas9 system with reportedly elegant features including cost -saving, target -design simplicity, robustness and efficiency would help researchers to investigate many cancers. In this study, lentiCRISPRv2-Cas9 mediated system was employed to generate indels for DUSP6 gene suppression in HT-29 CRC cell line. The DUSP6 site-specific guide RNAs (gRNAs) were designed using CRISPR design tool (http://crispr.mit.edu/) and cloned into lentiCRISPRv2 plasmid. The lentiCRISPRv2-DUSP6 was then transfected into HT-29 cell line using Lipofectamine 3000, incubated for three days, and the successfully transfected cells were selected for four days using puromycin. The genomic DNA was extracted from the transfected cells, and was analysed using GeneArt genomic cleavage detection assay. The assay shows the presence of three separated bands which marked successful generation of indels in DUSP6 gene in HT-29 cell line that would expectedly disrupt its reading frame causing gene suppression. However, further analysis of the gene suppression can be confirmed by real-time PCR and western-blot. Thus, our study suggests lentiCRISPRv2-mediated system can be successfully used to generate indels in DUSP6 gene for gene suppression in HT-29 CRC cell line. Contact author: Muhammad Khairi Ahmad; [email protected]

Acknowledgement: This work was funded by a grant from Fundamental Research Grant Scheme, Ministry of Higher Education Malaysia (Grant No. 203.CIPPT.6711505). Keywords: Colorectal cancer; DUSP6; lentiCRISPRv2-Cas9; Indels

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Roles of lipids in development of anticancer drug resistance in MCF7 cells

Auni Fatin Abdul Hamid1, Shahrul Bariyah Sahul Hamid1

1Oncological and Radiological Sciences Cluster, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Penang, 13200, Malaysia Breast cancer is the most common type of cancer among women world wide and it is the leading cause of death among women in Malaysia. Clinical data have indicated that oxidized low density lipoprotein (oxLDL) and very low density lipoprotein (VLDL) are involved in breast cancer progression. Despite the current advancement in technologies, drug resistance remains as a major obstacle in delivering effective breast cancer treatment. Therefore, this study aims to investigate the role of lipids in development of resistance to anticancer drugs. Tamoxifen-resistant MCF7 (Tam-R) was developed by pulse treatment method. The cells were exposed to gradual increase of tamoxifen concentration from 1 to 5 µM for 3 days in Dulbecco's Modified Eagle's medium (DMEM) without phenol red. This was followed by cell viability test to determine the fold-resistance of tamoxifen-treated cells relative to the parent MCF7 cells. It was done at concentration of tamoxifen between 0 to 100 µM. Further analysis was carried out through wound-healing assay. Two-hundred microliter tips were used to make a “wound” at the center of the well. Then, the cells were treated with 10 µg/mL of oxLDL and images were taken at 0 hour and 72 hour for comparison. From the cell viability test, results indicated that the Tam-R cells had 2-fold resistance which is considered as a clinically relevant drug-resistant cancer cell line model. After 72 hours of oxLDL treatment, both parent MCF7 and Tam-R cells showed higher percentage of wound closure compared to control. Tam-R cells had 34 % of wound closure, whereas parent MCF7 cells had 21 % of wound closure. This data suggests that oxLDL promotes cell migration in breast cancer cells and may play important role in increasing resistance against tamoxifen. Contact author: Auni Fatin Abdul Hamid; [email protected] Acknowledgement: This study was funded by Fundamental Research Grant Scheme (FRGS) Keywords: oxidized-low density lipoprotein, drug resistant, breast cancer


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